CAJ | 학술논문

目的：对老年糖尿病患者院内获得性肺部感染的临床特征进行分析，并提出相应的防治措施，以降低感染率。方法选取2011年6月－2013年6月医院收治的300例老年糖尿病患者，观察其发生院内获得性肺部感染的相关实验室指标，并制定相关防治措施。结果300例糖尿病患者中发生院内获得性肺部感染43例，感染率为14．3％；患者的年龄、住院时间、侵入性操作、糖化血红蛋白水平是老年糖尿病患者发生院内获得性肺部感染的重要影响因素（ P＜0．05）；43例肺部感染患者入院48 h呼吸系统特征分布显示，咳嗽、咳痰患者30例占69．8％，发热20例占46．5％，肺实变体征、啰音患者33例占76．7％，片状、斑状侵润性阴影或肺纹理增多等类圆形病灶患者38例占88．4％，血白细胞＞10×109／L或中性粒细胞＞70．0％患者23例占53．5％；43例肺部感染患者痰标本培养分离病原菌阳性23例，阳性率为53．5％；23例阳性标本共分离出病原菌29株，其中革兰阴性菌19株占65．52％，革兰阳性菌6株占20．69％，真菌4株占13．79％。结论老年糖尿病患者院内获得性肺部感染受多种因素影响，临床应及时进行诊断治疗，有效减少不良反应的发生。
목적：대노년당뇨병환자원내획득성폐부감염적림상특정진행분석，병제출상응적방치조시，이강저감염솔。방법선취2011년6월－2013년6월의원수치적300례노년당뇨병환자，관찰기발생원내획득성폐부감염적상관실험실지표，병제정상관방치조시。결과300례당뇨병환자중발생원내획득성폐부감염43례，감염솔위14．3％；환자적년령、주원시간、침입성조작、당화혈홍단백수평시노년당뇨병환자발생원내획득성폐부감염적중요영향인소（ P＜0．05）；43례폐부감염환자입원48 h호흡계통특정분포현시，해수、해담환자30례점69．8％，발열20례점46．5％，폐실변체정、라음환자33례점76．7％，편상、반상침윤성음영혹폐문리증다등류원형병조환자38례점88．4％，혈백세포＞10×109／L혹중성립세포＞70．0％환자23례점53．5％；43례폐부감염환자담표본배양분리병원균양성23례，양성솔위53．5％；23례양성표본공분리출병원균29주，기중혁란음성균19주점65．52％，혁란양성균6주점20．69％，진균4주점13．79％。결론노년당뇨병환자원내획득성폐부감염수다충인소영향，림상응급시진행진단치료，유효감소불량반응적발생。
OBJECTIVE To explore the clinical characteristics of hospital‐acquired pulmonary infections in the elder‐ly patients with diabetic mellitus and put forward corresponding prevention measures so as to reduce the infection rate .METHODS A total of 300 elderly patients with diabetic mellitus who were treated in the hospital from Jun 2011 to Jun 2013 were enrolled in the study ,then the related laboratory indicators for the hospital‐acquired pulmo‐nary infections were observed ,and the corresponding prevention measures were put forward .RESULTS The hospi‐tal‐acquired pulmonary infections occurred in 43 of 300 elderly patients with diabetic mellitus ,with the infection rate of 14 .3% .The age ,length of hospital stay ,invasive operation ,and level of glycated hemoglobin were the im‐portant influencing factors for the hospital‐acquired pulmonary infections in the elderly patients with diabetic melli‐tus (P<0 .05) .Of the 43 pulmonary infection patients with the length of hospital stay of 48 hours ,30 (69 .8% ) had cough and expectoration ,20 (46 .5% ) had fever ,33 (76 .7% ) had pulmonary consolidation signs and rales , 38 (88 .4% ) had oval lesions such as sheet ,porphyritic invasive shadow and increased lung markings ,and 23 (53 .5% ) had the white blood cell counts more than 10 × 109/L or the neutrophils more than 70 .0% .The sputum specimens were cultured positive in 23 of 43 patients with pulmonary infections ,with the positive rate of 53 .5% ;totally 29 strains of pathogens have been isolated from the 23 patients with positive culture of specimens ,including 19 (65 .52% ) strains of gram‐negative bacteria ,6 (20 .69% ) strains of gram‐positive bacteria ,and 4 (13 .79% ) strains of fungi .CONCLUSION There are a variety of influencing factors for the hospital‐acquired pulmonary infec‐tions in the elderly patients with diabetic mellitus .It is necessary for the hospital to conduct the diagnosis and treatment in a timely manner so as to effectively reduce the incidence of adverse reactions .