高龄院内获得性肺炎的诊治体会.docVIP

高龄院内获得性肺炎的诊治体会 梁文 卢乃棉 任丽艳 盛雅萍 江苏省苏州市明基医院老年科 X 关注成功！ 加关注后您将方便地在 我的关注中得到本文献的被引频次变化的通知！ 新浪微博 腾讯微博 人人网 开心网 豆瓣网 网易微博 摘????要： 目的:探讨高龄院内获得性肺炎的诊治方法。方法:收治院内获得性肺炎患者50例, 解析患者诊治状况、原始痰培养与药物敏感性、机械通气时间与病死率。结果:原始细菌培养阳性菌株, 其中革兰阴性菌株、铜绿假单胞菌占首位;革兰阳性菌均为耐甲氧西林金黄色葡萄球菌。初始细菌培养阳性患者中, 细菌适量组与细菌不适量组患者平均通气时间差异有统计学意义 (P0.05) 。结论:高龄院内获得性肺炎的致病菌耐药率高, 科学应用抗生素治疗该类疾病, 能够减缩患者机械通气时间, 强化临床治疗效果。 关键词： 院内获得性肺炎; 高龄患者; 耐药性; Diagnosis and treatment of hospital acquired pneumonia in elderly patients Liang Wen Lu Naimian Ren Liyan Sheng Yaping Department of Geriatrics, Mingji Hospital of Suzhou City, Jiangsu Province; Abstract： Objective:To investigate the diagnosis and treatment of hospital acquired pneumonia in the elderly patients.Methods:A total of 50 patients with hospital acquired pneumonia were enrolled in this study.The common condition, primary sputum culture and drug sensitivity, mechanical ventilation time and fatality rate were analyzed.Results:Among the original bacterial culture positive strains, the gram negative strains and pseudomonas aeruginosa accounted for the first place;gram positive strains were methicillin-resistant staphylococcal.In the initial bacterial culture positive patients, there was a statistically significant difference in the average ventilation time between the bacterial amount group and the bacterial deficiency group (P0.05) .Conclusion:The resistance rate of nosocomial pneumonia in elderly patients is high, and the scientific application of antibiotics can reduce the time of mechanical ventilation and strengthen the effect of clinical treatment. Keyword： Nosocomial pneumonia; Elderly patients; Drug resistance; 院内获得性肺炎 (HAP) 指无气管插管患者在入住医院病房≥2 d发生的肺炎, 具有病情严重、并发症多以及致死率高等特征。本文总结长期的临床实践经验, 对院内获得性肺炎高龄患者的诊治情况进行解析, 现做出如下总结。 资料与方法 2015年1月-2016年9月收治高龄HAP患者50例, 男32例, 女18例;年龄65~92岁, 平均 (82±4.7) 岁。所有患者行无创机械通气治疗, 合并感染性休克8例;早发HAP (病程5 d) 7例, 晚发HAP43例;平均住院时间 (17.2±3.4) d[1]。急性生理和慢性健康状态评分 (APACHEⅡ评分) 5~25分, 平均 (13.2±4.7) 分;50例患者都伴有不同程度的基础疾病, 慢性肺部疾病15例 (30.0%) , 慢性充血性心力衰竭16例 (