老年恶性肿瘤并发医院获得性肺炎的临床分析

目的：探讨老年恶性肿瘤并发医院获得性肺炎（hospital acquired pneumonia,HAP）的临床特点及病原学分析。方法回顾性分析157例老年晚期恶性肿瘤并发HAP的病例资料。结果中低热占88.5%，高热仅占11.5%；有呼吸系统症状者占76.2%，无呼吸系统症状而仅表现为精神萎靡者占23.8％；白细胞总数明显增高的仅占47.8％；65.6％的患者中性粒细胞比例明显增高；肺部听诊96.2％存在干、湿啰音。痰培养阳性率仅43.41％，其中革兰阴性菌占66.29％，革兰阳性菌占23.60％，真菌占10.11％。结论老年恶性肿瘤并发HAP发病率高，临床表现不同于其他患者，病原菌以革兰阴性菌为主。

The clinical characteristics of hospital acquired pneumonia in elderly patients with malignant tumor

Objective To investigate the clinical characteristics and pathogens in elderly patients with malignant tu-mor complicated with hospital acquired pneumonia. Methods The clinical data of 157 cases of elderly patients with ma-lignant tumor complicated with hospital acquired pneumonia were retrospectively analyzed. Results Low to moderate fe-ver occurred in 88.5%of patients, only 11.5%patients had high fever. 76.2%patients had respiratory symptoms (), only 23.8%patients had no respiratory symptoms but had lathergy . Only 47.8%patients had leukocytosis , the proportion of neutrophils was significantly increased in 65.6%of patients . Rales or rhonchi were detected in 96.2%patients during lung auscultation. Sputum culture was positive in 43.41% of patients, among which 66.29% were Gram negative bacteria, 23.6%were Gram positive bacteria, 10.11%were fungi. Conclusion The incidence HAP is high in elderly patients with malignant tumor . Clinical manifestations are different from those patients without malignant tumors, and the majority of them are infected with Gram negative bacteria.