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老年人革兰阴性杆菌肺炎近几年逐渐增多且病情重,预后差.现将我院1991年4月～1993年10月收治的老年人革兰阴性杆菌肺炎36例报告如下.1 临床资料36例中男26例,女10例;55～65岁12例、70岁以上24例.36例中属医院内感染8例.4例有雾化吸入器治疗史,14例应用糖皮质激素,10例有应用抗生素史.本组缓慢起病21例,起病急骤11例,有4例合并休克.临床症状发热29例,低热20例,高热9例.咳嗽36例,咳黄脓痰23例,其中痰脓发行发绿5例,白泡沫痰8例.有痰血23例,痰量50ml以上21例、气促18例,胸痛9例.肺部广泛湿性罗音24例.罗音局限于右下肺4例.左下肺3例.右中、上肺2例.3例可闻及胸膜摩擦音.白细胞增高20例,中性白细胞升高26例.其中12例做血培养阳性4例.所有病例皆做2次以上痰培养均为革兰阴性杆菌生长.36
Gram-negative elderly bacilli in recent years gradually increased and severe illness, the prognosis is poor now our hospital from April 1991 to October 1993 admitted to the elderly with gram-negative bacilli pneumonia 36 cases reported as follows.1 Clinical data 36 26 cases were male and 10 females, 12 cases 55 to 65 years old, 24 cases over the age of 70. 36 cases were hospital-based infections in 8. 4 cases with a history of inhalation therapy, 14 cases of glucocorticoid, 10 cases of history of the use of antibiotics.This group of slow onset in 21 cases, 11 cases of acute onset, 4 cases with shock.Clinical symptoms of fever in 29 cases, 20 cases of fever, fever in 9. Cough in 36 cases, cough yellow purulent sputum 23 Cases, of which 5 cases of phlegm issued green hair, white foam sputum in 8. There are 23 cases of sputum, more than 50ml sputum volume in 21 cases, 18 cases of shortness of breath, chest pain in 9. Extensive lung wet rales in 24 cases. Confined to the right lower lung in 4 cases.Lower left lung in 3 cases.The right middle and upper lung in 2 cases.3 cases can be heard and pleural friction sound.When white blood cells increased in 20 cases, neutrophils increased in 26 cases.Among them, 12 cases of blood culture positive 4 All cases were done more than 2 sputum cultures were gram-negative bacilli growth