上海宝山区n例老年人社区获得性肺炎的临床分析.DOCVIP

上海市二级医院医院获得性肺炎150例临床分析 张有志 梁永杰 秦兴国 【摘要】目的 分析上海市二级医院医院获得性肺炎的临床特点。方法 对上海市14家二级医院150例医院获得性肺炎患者的临床资料进行回顾性分析。结果 年龄34~96岁，男性87例（58.0%），女性63例（42.0%）。早发医院获得性肺炎36例（24.0%），晚发医院获得性肺炎114例（76.0%）。发热者124例（82.7%），有咳嗽、咳痰等呼吸道症状者148例（98.7%），有乏力、纳差等非特异性症状者48例（32.0%）。血常规白细胞数升高(≥10×109／L)78例(52.0%)，白细胞数正常而中性粒细胞升高 42例(28.0%)，白细胞数减少(≤4×109／L)7例(4.7%)，两者均正常23例(15.3%)。合并基础疾病者139例(92.7%)。死亡27例（18.0%）。分离出致病菌株,革兰阴性菌占%,革兰阳性菌占%，耐药菌占10.4% (16/152)。前三位致病菌依次为鲍曼不动杆菌(株)铜绿假单胞菌(株)和金黄色葡萄球菌(株)鲍曼不动杆菌金黄色葡萄球菌Clinical Analysis on 150 cases of hospital acquired pneumonia in Grade II hospital，shanghai *ZHANG Youzhi,LIANG Yongjie,QIN Xingguo.*Department of Pulmonary Medicine,Shidong Hospital,Shanghai,200438,China Corresponding author: QIN Xingguo, E-mail：shidongqxg@ [Abstract] Objective To analyse the clinical characteristics of hospital acquired pneumonia in Grade II hospital．Methods Retrospective analysis was used on the clinical data of HAP in 150 patients from 14 Grade II hospitals in shanghai．Results Totally 150 cases of HAP were retrieved ,including 87 male cases（58.0%） and 63 female cases（42.0%）．Mean age was (65.03±8.42) years （ranged from 34 to 96 years）．36 cases（24.0%）were diagnosed as Early-onset HAP , and 114 cases (76.0%) as late-onset HAP ． The main symptoms of HAP were fever （124 cases,82.7%）, cough and expectoration （148 cases,98.7%）, fatigue and anorexia （48 基金项目：上海市卫生局基金资助项目（2006Y072） 作者单位：200438 上海市杨浦区市东医院呼吸科（张有志、秦兴国）；同济大学附属东方医院呼吸科（梁永杰） 通信作者：秦兴国，电子邮箱为shidongqxg@ cases,32.0%）．White blood cells increased in 78 cases (52.0%) , neutrophil increased in 42 cases (28.0%),both were normal in 23 cases (15.3%)． 139 cases (92.7%) were accompanied with underlying diseases．27 cases（18.0%）died from HAP．The top five bacteria in 152 isolated pathogens were Klebsiella pneumoniae (32 cases, 21.1%) , Acinerobacter baumannii (28 cases, 18.4%), Streptococcus pneumoniae (22 cases, 14.5%), Pseudomonas aeruginosa (16 cases, 10.5%) and Staphylococcus aureus (16 cases, 10.5%)．Gram-negative bacteria (86.6%) wer