敏感社区获得性肺炎克雷伯菌肺炎救治结局分析(1)
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【摘要】 目的 探讨影响敏感社区获得性肺炎克雷伯菌肺炎救治结局的因素。方法 依据2006年社区获得性肺炎(Community-acquiredpneumonia,CAP,下同)诊断标准,回顾性分析我科2004年2月至2009年2月期间收治的对初始抗生素敏感的41例社区获得性肺炎克雷伯菌肺炎患者的临床资料,对存活组和死亡组的基础状态进行比较。结果 存在合并症者病死率高于无合并症者,相比较具有统计学意义(P<0.05);高龄、合并慢性酒精中毒、慢性阻塞性肺疾病及糖尿病患者的死亡率高,相比较具有统计学意义(P<0.05);4个影响救治结局的危险因素按OR值大小为年龄>慢性酒精中毒>慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD,下同)>糖尿病。结论 非病原学因素对社区获得性肺炎克雷伯菌肺炎患者救治结局的影响起重要作用,应积极改善患者基础状态。
【关键词】肺炎;社区获得性;肺炎克雷伯菌;基础状态
The treating reasult of the community-acquired Klebsiella pneumoniae pneumonia patients of which the pathogen was sensitive to the early antibiotics
FANGGui-ju,XUEQing,DENGXin-yu.
Department,Ningde Municipal Hospital,Fujian Medicial University of Pulmonary,Ningde 352100,China
【Abstract】 Objective To investigate the basic status of the community-acquired Klebsiellapneumoniae pneumonia patients.Methods According to the diagnosis standard of CAP in 2006,41 community-acquired Klebsiella pneumoniae pneumoniapatients in our hospital from February 2004 to February 2009 were analyzed retrospectively,of which the pathogens was sensitive to the early empirically application of antibiotics.Results The mortality rate of combinedbasic disease group was higher than that of less group,which has statistical significance(P<0.05).The mortality rate of the patients with advancde age,chronic alcoholism,COPD,and diabetes was higher,and has statistical significance(P<0.05).There were four risk fators associated with the prognosis of the patients.Aording to OR Value,were age>chronic alcoholism>COPD>diabetes.Conclusion To improve the prognosis of the community-acquired Klebsiella pneumoniae pneumonia patients,not only the pathogens but also the basic complications should be emphasized.
【Key words】Pneumonia; Community-acquired;Klebsiella pneumoniae; Basic Complications
DOI:10.3760/cma.j.issn 1673-8799.2010.06.52
作者单位:352100福建医科大学教学医院宁德市医院呼吸内科
肺炎克雷伯菌(klebsiella pneumoniae)是革兰染色阴性菌肺炎最重要的致病菌,由其引起的肺炎预后差,即使给予抗生素治疗,死亡率仍高达20%~50%[1]。现对本科2004年2月至2009年2月期间收治的对初始抗生素敏感的41例社区获得性肺炎克雷伯菌肺炎进行回顾性分析,就死亡组和存活组的部分临床特点进行比较,报告如下 ......
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