目的探讨高龄老年肺炎的临床特点及诊治概况。方法分析2003年1月至2006年6月在我院住院的65例80岁以上高龄老年肺炎患者临床资料。结果既往有心、肺、神经系统等基础疾病者发病多。临床症状多表现为咳嗽(42例),咯痰(36例),喘息或呼吸困难(31例),中低热(25例),非特异症状多见,易出现并发症。X线胸片以小片状、斑点状阴影多见(42例);血气分析以低氧血症多见(40例),可出现呼吸衰竭(19例)。CAP及HAP两组痰培养以革兰阴性杆菌感染多见,HAP组真菌感染明显高于CAP组。结论高龄老年肺炎临床表现不典型且复杂,咳嗽、咯痰、喘息或呼吸困难、中低热是高龄老年肺炎的主要临床表现,高热、寒战、胸痛不明显,消化和神经系统的非特异症状多见。X线胸片、血气分析及痰培养等辅助检查对该病的及时诊治非常重要。重视基础疾病的治疗与全身情况的改善有助于提高临床治愈率、好转率。 Objective To investigate the clinical features and diagnosis and treatment of senile pneumonia. Methods Clinical data of 65 elderly patients aged over 80 with pneumonia admitted in our hospital from January 2003 to June 2006 were analyzed. Results previous heart, lung, nervous system and other basic diseases and more. More clinical manifestations were cough (42 cases), expectoration (36 cases), wheezing or breathing difficulties (31 cases), moderate to hypothermia (25 cases), nonspecific symptoms are more common, prone to complications. X-ray chest to small pieces, spot-shaped shadow more common (42 cases); blood gas analysis to more common hypoxemia (40 cases), respiratory failure can occur (19 cases). Gram-negative bacilli were more common in both CAP and HAP sputum cultures, and fungal infections in HAP group were significantly higher than those in CAP group. Conclusions The clinical manifestations of senile pneumonia are atypical and complicated, with cough, expectoration, wheezing or breathing difficulties. Moderate-low fever is the main clinical manifestations of senile pneumonia. High fever, chills and chest pain are not obvious, and the non-specific symptoms of digestive and nervous system are common . X-ray, blood gas analysis and sputum culture and other auxiliary examination of the timely diagnosis and treatment of the disease is very important. The emphasis on the treatment of underlying diseases and the improvement of the general condition help to improve the clinical cure rate and improvement rate.