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目的探讨老年人院内获得性肺炎(HAP)的临床、病原学特点、易患因素及防治对策。方法对36例老年HAP患者进行回顾性分析。结果36例老年HAP患者的临床表现不典型,病原菌主要以Gˉ杆菌为主,占71.1%;同时两种细菌或细菌和真菌的混合感染严重,占46.2%。革兰氏阴性菌主要对头孢哌酮、头孢他啶、泰能、氧哌嗪青霉素、环丙沙星、丁胺卡那霉素敏感;而G+主要是金黄色葡萄球菌,主要对万古霉素敏感。结论老年人生理功能的退变,机体抵抗力低下,合并慢性基础疾病,营养不良、肺功能低下,同时反复大量使用多种抗生素,是造成HAP的主要危险因素;增强免疫功能、加强营养及病房的空气消毒是主要的防治措施。
Objective To investigate the clinical and etiological characteristics, risk factors and prevention and treatment of nosocomial pneumonia (HAP) in the elderly. Methods 36 elderly HAP patients were retrospectively analyzed. Results The clinical manifestations of 36 elderly patients with HAP were not typical. The pathogens were mainly Bacillus coli, accounting for 71.1%. In addition, the two bacteria or bacteria and fungi mixed infection accounted for 46.2%. Gram-negative bacteria are mainly sensitive to cefoperazone, ceftazidime, tacrine, piperacillin, ciprofloxacin, amikacin; and G + is mainly Staphylococcus aureus, mainly to vancomycin. Conclusions Degradation of physiological function, low body resistance, combined with chronic basic diseases, malnutrition, low lung function, and repeated use of multiple antibiotics in the elderly are the main risk factors for HAP; enhance immune function, enhance nutrition and ward Air disinfection is the main control measures.