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目的探讨老年社区获得性肺炎(CAP)的临床及影像学特点与治疗转归。方法 150例老年人社区获得性肺炎住院患者的临床及影像学资料,对其进行回顾性分析。结果 150例中合并有心、脑血管及慢性阻塞性肺疾病(COPD)等基础疾病者114例(76.0%),具有发热及白细胞升高分别为53例(35.3%)及39例(26.0%);有呼吸道症状者125例(83.3%)。影像学检查胸片检查132例,漏诊34例(25.8%);CT检查89例,100%阳性发现;107例(71.3%)表现为沿支气管分布小斑片状模糊阴影呈小叶性肺炎改变;98例(65.3%)为两侧肺炎。治疗病程平均37.4 d,5例因并发症死亡。结论老年社区获得性肺炎患者较多合并有基础疾病;临床表现不典型,病情较重;影像学检查胸部平片有漏诊存在,CT是重要的补充检查,多为小叶性肺炎,两肺发病多见;该病治疗疗程较长,部分病例预后不良,应该引起重视。
Objective To investigate the clinical and imaging characteristics and treatment outcome of senile community acquired pneumonia (CAP). Methods The clinical and imaging data of 150 elderly patients with community-acquired pneumonia in hospital were retrospectively analyzed. Results A total of 114 patients (76.0%) with fever, leukocytopenia were found in 53 cases (35.3%) and 39 cases (26.0%) with fever, leukocytosis in 150 patients with underlying diseases including heart, cerebrovascular and chronic obstructive pulmonary disease 125 cases had respiratory symptoms (83.3%). Radiography was performed in 132 cases of chest X-ray examination and 34 cases of missed diagnosis (25.8%). CT examination was performed in 89 cases and 100% positive findings were found. In 107 cases (71.3%), lobular pneumonia was seen along the bronchial patchy fuzzy shadow. 98 cases (65.3%) were bilateral pneumonia. The duration of treatment was 37.4 days on average, and 5 patients died of complications. Conclusions Elderly patients with community-acquired pneumonia are more likely to have underlying diseases. The clinical manifestations are not typical and their condition is severe. Imaging diagnosis of chest radiographs may be a missed diagnosis. CT is an important supplementary examination, mostly lobular pneumonia, and the incidence of both lungs is high See; longer course of treatment of the disease, some cases of poor prognosis, it should be taken seriously.