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目的探讨老年吸入性肺炎的临床特点,为其临床诊治提供依据。方法选择山东大学千佛山医院收治的76例老年吸入性肺炎患者,回顾性分析其合并基础疾病情况、临床表现、病原学检查及治疗、转归情况。结果绝大部分老年吸入性肺炎患者合并有基础疾病,其中合并神经系统疾病居首位,占65.79%(50/76);痰培养病原学检查前三位分别为为肺炎克雷伯菌(25.49%)、大肠埃希菌(12.75%)、铜绿假单胞菌(11.76%);本组最终死亡率为13.76%,死亡的患者均至少合并3种基础疾病。结论老年吸入性肺炎患者临床表现不具有典型性,宜采用降阶梯疗法并根据药敏结果应用抗生素治疗;对于合并3种以上基础疾病的老年患者,应给予积极治疗。
Objective To investigate the clinical features of elderly patients with aspiration pneumonia and provide the basis for its clinical diagnosis and treatment. Methods Seventy-six elderly patients with inhaled pneumonia who were admitted to Qianfoshan Hospital of Shandong University were retrospectively analyzed. Their underlying diseases, clinical manifestations, etiological examination, treatment and prognosis were retrospectively analyzed. Results The majority of patients with asymptomatic pneumonia were complicated with underlying diseases, of which 65.79% (50/76) had the most common neurological diseases. The top three pathogens of sputum culture were Klebsiella pneumoniae (25.49 %), Escherichia coli (12.75%) and Pseudomonas aeruginosa (11.76%). The final death rate in this group was 13.76%, and at least 3 basic diseases were combined with death. Conclusion The clinical manifestations of elderly patients with aspiration pneumonia are not typical, should be used step-down therapy and antibiotic susceptibility results based on the application of antibiotics; for more than three kinds of underlying diseases in elderly patients should be given active treatment.