中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2012年
16期
35-37
,共3页
糖尿病%老年患者%医院获得性肺炎
糖尿病%老年患者%醫院穫得性肺炎
당뇨병%노년환자%의원획득성폐염
Diabetes mellitus%Elderly patients%Hospital acquired pneumonic infection
目的 探讨老年糖尿病患者并发医院获得性肺炎的临床特点及其防治策略.方法 回顾性分析68例老年糖尿病并发医院获得性肺炎患者的临床资料,包括痰细菌培养及药敏试验结果、治疗及转归情况.结果 68例老年糖尿病并发医院获得性肺炎患者发病率为9.44％,伴有咳嗽、咳痰、发热等呼吸道症状者42例,占61.7％,无呼吸道症状26例,占38.3％；肺部听诊可闻及肺部啰音52例,占76.4％；胸片均发现有肺部感染.痰细茵培养出59株细菌,其中41株(69.5％)为G-杆菌,15株(25.4％)为G+球菌.使用抗生素治疗后54例痊愈,14例(20.6％)死亡.结论 老年糖尿病患者医院获得性肺炎发生率高,且病死率高,部分患者感染症状不典型,应将胸部X线检查作为常规检查；痰细菌培养以G-杆菌为主,经验性使用抗生素应注意覆盖G-杆菌,然后按药敏试验结果选用敏感抗生素治疗.
目的 探討老年糖尿病患者併髮醫院穫得性肺炎的臨床特點及其防治策略.方法 迴顧性分析68例老年糖尿病併髮醫院穫得性肺炎患者的臨床資料,包括痰細菌培養及藥敏試驗結果、治療及轉歸情況.結果 68例老年糖尿病併髮醫院穫得性肺炎患者髮病率為9.44％,伴有咳嗽、咳痰、髮熱等呼吸道癥狀者42例,佔61.7％,無呼吸道癥狀26例,佔38.3％；肺部聽診可聞及肺部啰音52例,佔76.4％；胸片均髮現有肺部感染.痰細茵培養齣59株細菌,其中41株(69.5％)為G-桿菌,15株(25.4％)為G+毬菌.使用抗生素治療後54例痊愈,14例(20.6％)死亡.結論 老年糖尿病患者醫院穫得性肺炎髮生率高,且病死率高,部分患者感染癥狀不典型,應將胸部X線檢查作為常規檢查；痰細菌培養以G-桿菌為主,經驗性使用抗生素應註意覆蓋G-桿菌,然後按藥敏試驗結果選用敏感抗生素治療.
목적 탐토노년당뇨병환자병발의원획득성폐염적림상특점급기방치책략.방법 회고성분석68례노년당뇨병병발의원획득성폐염환자적림상자료,포괄담세균배양급약민시험결과、치료급전귀정황.결과 68례노년당뇨병병발의원획득성폐염환자발병솔위9.44％,반유해수、해담、발열등호흡도증상자42례,점61.7％,무호흡도증상26례,점38.3％；폐부은진가문급폐부라음52례,점76.4％；흉편균발현유폐부감염.담세인배양출59주세균,기중41주(69.5％)위G-간균,15주(25.4％)위G+구균.사용항생소치료후54례전유,14례(20.6％)사망.결론 노년당뇨병환자의원획득성폐염발생솔고,차병사솔고,부분환자감염증상불전형,응장흉부X선검사작위상규검사；담세균배양이G-간균위주,경험성사용항생소응주의복개G-간균,연후안약민시험결과선용민감항생소치료.
Objective To investigate the clinical features and control strategy of elderly diabetic patients complicated with hospital acquired pneumonia.Methods Retrospective analysis was taken for 68 elderly patients with diabetes mellitus complicated with hospital acquired pneumonia,including results of sputum bacterial cultivation with drug sensitivity test,treatment and prognosis.Results The incidence of hospital acquired pneumonia was 9.44％,42 cases (61.7％) had cough,expectorations and fever,26 cases(38.3％ ) had no respiratory symptoms,but 52 cases(76.4％ ) had rales on auscultation of lung.All patients had shadow in the lungs in X-ray film.There were 59 strains of bacteria in sputum cultivation,among which,41 strains(69.5％ ) were gram-negative bacterium and 15 strains(25.4％ )were gram-positive bacterium.After antibiotics treatment 54 cases were cured and 14 cases (20.6％ )died.Conclusions The incidence of hospital acquired pneumonia in elderly diabetes mellitus is high,and the mortality is high,some have no typical signs of infection,therefore,chest X-ray examination should be considered as routine check up.The gram-negative bacterium in sputum cultivation is most seen.Empirical use of antibiotics must cover gram-negative bacterium,then select sensitive antibiotics by drug-sensitive- tests results.
