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目的 :探讨急诊高龄卫生保健相关性肺炎(HCAP)患者的临床特征及预后。方法 :对2012年1月至2013年12月急诊病房收治的年龄>80岁的高龄肺部感染患者的临床资料进行回顾性分析,比较社区获得性肺炎(CAP)组与HCAP组患者的临床特征、病原学特点及预后。结果:165例高龄肺部感染患者中,HCAP组患者的平均住院天数[(19.9±12.3)d]显著长于CAP组[(14.6±7.4)d](P<0.05),且病死率显著高于后者(22.9%比7.3%,P<0.05)。2组患者症状不典型,有基础疾病者142例(86.1%)。2组患者均存在营养不良。HCAP组患者入院时的肺炎严重度指数(PSI)显著高于CAP组(125.2±27.1比116.8±25.8,P<0.05),PSI评分Ⅴ级的比例也显著高于后者(38.6%比23.2%,P<0.05)。结论 :高龄肺部感染患者基础疾病多,营养状况差,临床症状不典型,特别是HCAP患者入院时病情重,住院时间长,病死率高,早期诊断与治疗具有重要的临床意义。
Objective: To investigate the clinical characteristics and prognosis of elderly patients with acute health care-associated pneumonia (HCAP). Methods: A retrospective analysis was performed on the clinical data of elderly patients aged> 80 years with acute lung injury admitted to emergency ward from January 2012 to December 2013. The clinical characteristics of community-acquired pneumonia (CAP) group and HCAP group were compared , Etiology and prognosis. Results: Among 165 elderly patients with pulmonary infection, the average length of hospital stay in HCAP group was significantly longer than that in CAP group [(14.6 ± 7.4) days] [(19.9 ± 12.3) days], and the mortality rate was significantly higher The latter (22.9% vs. 7.3%, P <0.05). Two groups of patients with atypical symptoms, there are 142 cases of underlying diseases (86.1%). Both groups had malnutrition. The pneumonia severity index (PSI) at admission in HCAP group was significantly higher than that in CAP group (125.2 ± 27.1 vs 116.8 ± 25.8, P <0.05), and the PSI score was significantly higher in V class than the latter (38.6% vs. 23.2% , P <0.05). Conclusion: There are many basic diseases, poor nutritional status and atypical clinical symptoms in elderly patients with pulmonary infection. Especially HCAP patients are seriously ill, hospitalized for a long time and have high mortality rate. Early diagnosis and treatment have an important clinical significance.