糖尿病患者合并医院获得性肺部感染临床分析

目的对合并医院获得性肺部感染的糖尿病患者进行临床分析。方法就我院自2011年1～12月收治的合并医院获得性肺部感染的糖尿病患者的资料进行回顾性临床分析。对经过确诊合并医院获得性肺部感染糖尿病患者进行其感染因素的观察,观察患者致病菌的抗菌药物敏感性和患者的疗效。结果年龄≥60岁、有肺部基础疾病、住院时间≥30d、有吸烟史的糖尿病患者医院获得性肺部感染的几率大大增加,感染的糖尿病患者的致病菌种以肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌、大肠埃希菌、白色念珠菌和金黄色葡萄球菌为主,革兰氏阴性菌感染者对亚胺培南、阿米卡星的敏感性均较高,革兰氏阳性菌感染者对万古霉素的敏感性较高(P<0.05)。44例合并医院获得性肺部感染者中36例病情得到有效控制,7例经治疗无效而死亡,1例选择转院治疗。结论医生应对合并医院获得性肺部感染的患者给予高度重视,进行实验室检查以确诊患者的致病菌,针对具体致病菌的抗菌治疗。加强对糖尿病患者,尤其是老年患者机械性通气、住院时间、肺部基础疾病、吸烟等致病因素的控制,积极防治感染,降低死亡率,提高患者生活质量。

Clinical Analysis on Diabetes Patients Complicated with Hospital Acquired Lung Infection

Objective To analyze the merged hospital-acquired pulmonary infection patients with diabetes.Method The data of diabetic patients with acquired pulmonary infection from January to Decem- ber 2011 were taken for retrospective clinical analysis.The infected factors of diagnosed as hospital-ac- quired pulmonary infection patients with diabetes,the antimicrobial susceptibility of pathogenic bacteria and the efficacy were observed.Results The diabetic patients with ~〉60 years of age,lung underlying diseases,length of stay ~〉30 days and,smoking history had more risk of hospital-acquired infection. Pathogens of infection in diabetic patients were mainly klebsiella pneumoniae,pseudomonas aeruginosa, acinetobacter action of bacteria,escherichia coli,candida albicans and gold aureus.Gram-negative bacteria infection had a higher sensitivity to imipenem and amikaein,while gram-positive bacteria-infected patients had a higher sensitivity to vancomycin（P〈0.05）.There were 36 patients were effectively controlledamong the 44 patients with hospital acquired lung infections,seven cases were failure and died,and one patient transferred to other hospital.Conclusions Physicians should pay attention to patients with merged hospital-acquired lung infection,take laboratory examination to diagnose the pathogens,and take antimicrobial therapy for specific pathogens.Strengthening the control of diabetic patients,especially me- chanical ventilation for elderly patients,length of stay,basal lung diaease,smoking and other risk factors, could prevent and treat the infection,reduce the mortality and improve patients＇quality of life.