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1987～1994年,我们收治老年细菌性肺炎84例,起病缓慢65例,急骤19例。主要临床表现为发热、畏寒、咳黄痰或血痰、胸痛、呼吸困难及厌食等;少数有精神错乱、反应迟钝等;主要体征为肺实变征、肺部干湿性罗音、支气管呼吸音等。白细胞升高41例,血细菌培养阳性4例。痰细菌培养阳性62例;其中绿脓杆菌21例,大肠杆菌14例,肺炎杆菌9例,肺炎链球菌8例,金黄色葡萄球菌5例,产气杆菌3例,流感杆菌2例。X线检查示支气管肺炎62例,大叶或节段型肺炎14例,混合型肺炎8例。合并电解质紊乱14例,休克14例,心衰10例,肺性脑病和DIC各6例,上消化道出血3例。经综合治疗痊愈40例,好转26例,死亡18例。
From 1987 to 1994, we admitted 84 cases of elderly bacterial pneumonia, 65 cases of slow onset, 19 cases of flash. The main clinical manifestations of fever, chills, cough and phlegm or bloody sputum, chest pain, dyspnea and anorexia; a few have mental disorders, unresponsive; the main signs of lung real change, lung wet and dry rales, bronchial breathing Tone and so on. 41 cases of leukocytosis, blood culture positive in 4 cases. Sputum bacterial culture positive in 62 cases; of which 21 cases of Pseudomonas aeruginosa, Escherichia coli in 14 cases, Klebsiella pneumoniae in 9 cases, Streptococcus pneumoniae in 8 cases, Staphylococcus aureus in 5 cases, 3 cases of Aerobacter aerogenes, 2 cases of influenza bacilli. X-ray examination showed bronchial pneumonia in 62 cases, large leaf or segmental pneumonia in 14 cases, mixed pneumonia in 8 cases. Electrolyte disturbance in 14 cases, shock in 14 cases, heart failure in 10 cases, pulmonary encephalopathy and DIC in 6 cases, 3 cases of upper gastrointestinal bleeding. After the comprehensive treatment of 40 cases cured, improved in 26 cases, 18 cases of death.