老年肺炎临床诊断与治疗专家共识(2024年版)  

Chinese expert consensus on the diagnosis and treatment of pneumonia in the elderly(2024 Edition)

作　　者：无 童朝晖[2] 施毅 无;Tong Zhaohui;Shi Yi(Respiratory Branch of Chinese Geriatrics Society;不详)

机构地区：[1]中国老年医学学会呼吸病学分会 [2]首都医科大学附属北京朝阳医院呼吸与危重症医学科,北京100020 [3]南京大学医学院附属金陵医院呼吸与危重症医学科,南京210002

出　　处：《中华结核和呼吸杂志》2025年第1期18-34,共17页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：科技部国家重点研发计划(2023YFC0872500);科技部国家重点研发计划(2022YFC2303200)。

摘　　要：中国已经进入老年化社会,而老年人是罹患肺炎的高危人群。老年肺炎具有起病隐匿、进展迅速、合并症多、预后差、发病率和病死率高等特点,需要引起临床医师的重点关注,制定更为精细的诊治策略,最大程度地保证个体化治疗。为加强对老年肺炎的防治与管理,本共识参照国内外最新相关指南与共识,结合该研究领域的最新进展,以问答的方式阐述了17个临床诊断、治疗和预防的问题,提出了13条推荐意见,从老年肺炎的病因及发病机制、诊断、病情评估、治疗和预防等方面提出意见和建议,以期为防治老年肺炎,改善老年患者的生活质量,降低住院及病死率,促进健康老龄化提供参考。China is experiencing a demographic shift as its population ages.The elderly population becomes increasingly susceptible to pneumonia.Pneumonia in the elderly is characterized by its insidious onset,rapid progression,multiple comorbidities,poor prognosis,and high morbidity and mortality.Physicians need to pay attention to developing more comprehensive diagnostic evaluations and treatment strategies,and ensuring personalized care to the greatest extent.In order to improve the prevention and management of pneumonia in elderly,this consensus incorporates the latest guidelines and consensus from both domestic and international sources.The latest progress in this research field is also included.The document addresses 17 clinical issues in a question-and-answer format and provides 13 recommendations on the etiology,pathogenesis,clinical diagnosis,treatment,and prevention of pneumonia in older adults.It provides reference for the prevention and treatment of pneumonia in elderly,improving their quality of life,reducing hospitalization and mortality,and promoting healthy aging.The specific recommendations are as follows.Recommendation 1:The main risk factors for pneumonia in the elderly include age(Recommended LevelⅠA),age-related systemic factors(such as poor physical condition,underlying diseases,and concomitant medications),and specific factors(specifically dysphagia and aspiration).The risk increases progressively with age(Recommended LevelⅡ-1A).Recommendation 2:Pneumonia in elderly individuals often presents with an insidious onset and atypical respiratory symptoms,especially in super-elderly patients.Initially,symptoms may include fatigue,loss of appetite,and disturbance of consciousness.Moreover,elderly patients often have underlying conditions such as pulmonary,cardiovascular,and neurological disorders,which can lead to rapid deterioration,multiple complications and sequelae.Pneumonia-related laboratory parameters in the elderly lack typical characteristic changes(Recommended LevelⅢA).The high proportion of

关 键 词：老年肺炎 个体化治疗 健康老龄化 临床医师 诊治策略 病情评估 老年患者 推荐意见 

分 类 号：R563.1[医药卫生—呼吸系统]