CAJ | 학술논문

目的：分析第三军医大学西南医院近3年老年肺炎的发病特征和并发症，为指导老年肺炎的临床合理综合治疗提供依据。方法分析2007年1月至2009年12月在第三军医大学西南医院老年科病房住院、年龄＞70岁112例老年肺炎患者的临床特征及并发症，了解社区获得性肺炎和医院获得性肺炎的症状、体征、影像学特点，以及常见的并发症、肺部感染诱发因素。结果＞70岁老年肺炎患者中，医院获得性肺炎比例有增加趋势，共占54.6%，症状体征多不典型，病情明显较社区获得性肺炎重，死亡率高，并发症多，影像学特点多变。最常见的前5位并发症分别为多器官功能衰竭、心力衰竭、呼吸衰竭、混合性电解质紊乱、营养性贫血。常见的前5位诱因依次为误吸、反流、脑梗死、心力衰竭、外科手术。结论3年来第三军医大学西南医院老年肺炎有逐年增加的趋势，尤以医院获得性肺炎发病率更高，症状体征多不典型，易合并严重并发症，及时防治诱因和合理综合治疗非常重要。
목적：분석제삼군의대학서남의원근3년노년폐염적발병특정화병발증，위지도노년폐염적림상합리종합치료제공의거。방법분석2007년1월지2009년12월재제삼군의대학서남의원노년과병방주원、년령＞70세112례노년폐염환자적림상특정급병발증，료해사구획득성폐염화의원획득성폐염적증상、체정、영상학특점，이급상견적병발증、폐부감염유발인소。결과＞70세노년폐염환자중，의원획득성폐염비례유증가추세，공점54.6%，증상체정다불전형，병정명현교사구획득성폐염중，사망솔고，병발증다，영상학특점다변。최상견적전5위병발증분별위다기관공능쇠갈、심력쇠갈、호흡쇠갈、혼합성전해질문란、영양성빈혈。상견적전5위유인의차위오흡、반류、뇌경사、심력쇠갈、외과수술。결론3년래제삼군의대학서남의원노년폐염유축년증가적추세，우이의원획득성폐염발병솔경고，증상체정다불전형，역합병엄중병발증，급시방치유인화합리종합치료비상중요。
Objective To investigate the clinical features and complications of aged patients with pneumonia from our hospital in the past 3 years in order to provide a basis for the reasonable clinical comprehensive treatment of these patients. Methods Clinical data of 112 aged patients over 70 years old with pneumonia hospitalized in our department from January 2007 to December 2009 were collected and analyzed. The clinical features and complications were analyzed. Causative factors of pulmonary infection, common complications, symptoms, signs, and imaging characteristics were analyzed for community-acquired pneumonia and hospital-acquired pneumonia. Results The incidence of hospital-acquired pneumonia was in an increased trend in the cohort, accounting for 54.6%. The patients with hospital-acquired pneumonia had non-typical symptoms and signs, higher mortality, more complications, and severe pathogenic conditions and more changeful radiological features when compared with those of community-acquired pneumonia. The top 5 complications were multiple organ failure, heart failure, respiratory failure, multiple electrolyte disturbances, and alimentary anemia. The first 5 precipitating factors were aspiration, regurgitation, cerebral infarction, heart failure and surgical procedures. Conclusion The incidence of pneumonia especially the hospital-acquired pneumonia in the elderly is increasing year by year in the past 3 years in our hospital. Meanwhile, the hospital-acquired pneumonia usually has non-typical symptoms and signs, and is commonly combined with severe complications. It is of great importance to prevent precipitating factors and give reasonable combined treatment for these patients.