CAJ | 학술논문

目的探讨慢性呼吸衰竭急性加重(ACRF)期呼吸道分泌物细菌学结果与病程、预后的关系. 方法 44例ACRF患者(49例次)进行气道分泌物细菌培养及耐药分析,观察细菌培养结果、耐药性与ACRF发作住院次数的相关性及对病死率的影响. 结果患者气道分泌物痰茵阳性率为63.3%,其中铜绿假单胞茵等非传统病原体占80.7%.ACRFI>2次/年组致病菌阳性率是ACRF<2次/年组的2倍(P<0.01).致病菌中耐药菌占61.3%,耐药菌阳性患者机械通气时间、住院天数较阴性者显著延长,病死率显著增高(P<0.05). 结论 ACRF患者主要致病菌为铜绿假单胞茵等非传统病原体,致病菌阳性率、非传统病原体比率随慢性呼吸衰竭的加重而增高,耐药菌感染导致ACRF病死率增高.
목적 탐토만성호흡쇠갈급성가중(ACRF)기호흡도분비물세균학결과여병정、예후적관계. 방법 44례ACRF환자(49례차)진행기도분비물세균배양급내약분석,관찰세균배양결과、내약성여ACRF발작주원차수적상관성급대병사솔적영향. 결과 환자기도분비물담인양성솔위63.3%,기중동록가단포인등비전통병원체점80.7%.ACRFI>2차/년조치병균양성솔시ACRF<2차/년조적2배(P<0.01).치병균중내약균점61.3%,내약균양성환자궤계통기시간、주원천수교음성자현저연장,병사솔현저증고(P<0.05). 결론 ACRF환자주요치병균위동록가단포인등비전통병원체,치병균양성솔、비전통병원체비솔수만성호흡쇠갈적가중이증고,내약균감염도치ACRF병사솔증고.
Objecfive To investigate the association between bacteriology of airway secretions in acute onset chronic respiratory failure (ACRF) and its clinical prognosis.Methods The bacterial flora and antibiotic resistance in the airway secretions from 44 patients with 49 cases of ACRF were studied,the associations between bacteriology,antibiotic resistance and annual ACRF hospital admission frequency (ACRF≥2 or ACRF<2),its mortality were also explored.Results Positive rate of culture in airway secretions was 63.3%.Untraditional pathogens such as Pseudomonas Aeruginosa accounted for 80.7%.The bacterial yield of patients with ACRF≥2 was twice as that with ACRF<2 (P<0.01).Of the identified bacteria,61.3% displayed antibioticresistance,and there was signifi-cant prolongation of ventilation and hospitalization and increase of mortality in patients with antibiotic resistance(P<0.05).Conclusion There is a predominance of untraditional pathogens such as Pseudomonas Aeruginosa in bacteria from airway secretions of ACRF patients,positive yield and percentage of untraditional pathogens increased with the severity of chronic respiratory failure,infections caused by antibiotic-resistant strains led to higher mortality in ACRF.