高龄2型糖尿病合并肺部感染68例临床分析

目的 探讨高龄2型糖尿病合并肺部感染患者的临床特点、发病原因、病原菌分布及诊断、治疗方法.方法 回顾性分析医院2007年12月—2011年5月收治的68例高龄2型糖尿病合并肺部感染患者的诊治资料,总结此类患者的临床特点、发病原因、病原菌分布、诊断方法及治疗方法.结果 此类患者的临床症状表现不具典型性,患者一般因出现肺部感染症状而入院,77.9％的患者有糖尿病史,22.1％的患者因出现肺部感染症状就诊后诊断出糖尿病；高血糖、低氧血症是导致高龄2型糖尿病患者易合并肺部感染的主要原因；检出的病原菌以肺炎克雷伯菌、铜绿假单胞菌为主,占38.6％、19.3％;通过X线片及痰菌培养、空腹血糖及餐后2h血糖测定等可确诊.结论 高龄肺部感染患者在就诊时,应常规进行血糖检测,防止出现糖尿病的漏诊而延误病情,在治疗中把握好患者控制血糖和抗感染两大环节,可有效提高治愈率.

Clinical analysis of 68 cases of senile patients with Type 2 diabetes and pulmonary infections

OBJECTIVE To investigate the clinical characteristics,etiology,pathogen distribution,diagnosis,and treatment for old patients with Type 2 diabetes and pulmonary infections.METHODS The diagnosis and treatment data of 68 cases of old patients with Type 2 diabetes and pulmonary infections who were enrolled from Dec 2007 to May 2011 were analyzed retrospectively,the clinical features,the etiology,pathogen distribution,diagnosis and treatment of these patients were summarized.RESULTS The clinical symptoms were non-typical.Patients were usually admitted to hospital because of pulmonary infection.There were 77.9% of the patients with a history of diabetes,22.1% of the patients diagnosed as diabetes after treatment for pulmonary infections;the high blood sugar and hypoxemia were the main causes leading to pulmonary infections in old patients with Type 2 diabetes;the main isolated pathogens were Klebsiella pneumoniae(38.6%) and Pseudomonas aeruginosa(19.3%);it could be diagnosed by X-ray,sputum culture,fasting glucose,and 2h postprandial blood glucose.CONCLUSION As for the treatment of the old patients with pulmonary infections,it is necessary to perform routine blood glucose testing so as to prevent the misdiagnosis and delayed diagnosis of diabetes;to grasp the control of blood sugar and anti-infection during the treatment can improve the cure rate effectively.