【作者】 吴雷琪；

【导师】 董旭南；

【作者基本信息】 新疆医科大学 ， 急诊医学， 2011， 硕士

【摘要】 目的：通过收集我院近十年以来的老年重症社区获得性肺炎患者的临床资料,回顾性分析我院老年重症社区获得性肺炎的临床特征,并探讨影响预后的相关因素,为进一步提高临床治疗效果提供参考依据。方法：收集我院2000年1月-2010年1月60岁以上的重症社区获得性肺炎患者117例,根据临床病史资料记录患者基本信息、生命体征、总住院天数,入住ICU的情况、既往各系统疾病及手术史；并且记录起病早期的临床症状,入院后的实验室检查以及影像学表现；回顾性分析患者的临床资料,采用描述性研究方法对所收集病例的一般临床资料进行分析。用logistic回归进行多因素分析的方法对老年SCAP患者的基本资料进行比较,有意义的因素进入循环中。结果：经综合治疗措施(包括抗感染、辅助呼吸治疗、免疫治疗、支持治疗以及痰液引流等)后,其中58例预后佳(好转),59例预后差(死亡,包括经治疗后无好转放弃治疗,出院后经电话随访已死亡的患者)。logistic回归方程结果显示影响老年人重症社区获得性肺炎预后的危险因素为人工气道、有基础疾病、多脏器功能衰竭、呼吸性酸中毒、低蛋白血症、低钠血症、年龄。结论：应重视危险因素对预后的影响,动态观察各项指标,对临床预防和治疗提供参考,及时、正确处理,改善患者病情,降低死亡率,提高治疗成功率。更多还原

【Abstract】 Objective:our hospital nearly a decade older patients with severe community-acquired pneumonia clinical data, reviewed in our hospital of severe community-acquired pneumonia clinical features and prognostic factors of influence, in order to further improve the clinical Provide the reference treatment. Methods:our hospital in January 2000-2010 on January 60 over the age of patients with severe community-acquired pneumonia in 117 cases (excluding patients with malignant tumors of pneumonia), according to data recorded the patient clinical history information, vital signs, The total length of hospital stay, ICU stay the case, past history of the disease, and surgery; and records of early onset of clinical symptoms, laboratory tests after admission and imaging; retrospective analysis of clinical data, using descriptive research method The general case of the clinical data collected for analysis. Multivariate logistic regression using the method of analysis of elderly patients with basic information on SCAP comparison meaningful factors into circulation. Results The comprehensive treatment measures (including anti-infection, secondary respiratory therapy immunotherapy, supportive care, and sputum drainage, etc.), one of the 58 patients with good prognosis (better),59 patients with poor prognosis (death, including after treatment without Better to give up treatment after discharge by telephone follow-up of dead patients). logistic regression showed that among older people with severe community acquired pneumonia prognostic factors for the artificial airway, there is underlying disease, multiple organ failure, respiratory acidosis, hypoproteinemia, hyponatremia, age. Conclusion:should pay attention to the impact of risk factors on the prognosis of the dynamic observation of the targets for clinical prevention and treatment of reference, timely and correct treatment, to improve the patient’s condition and reduce mortality and improve the treatment success rate.更多还原