急诊肺炎与抗生素合理应用的临床研究

目的：了解急诊肺炎的病原体分布、药敏试验、抗生素的使用以及影响预后因素。方法：对本急救中心2001年11月～2003年10月收治的70例急诊肺炎的临床特点、病原学资料、治疗和转归进行回顾性分析。结果：(1)单一肺炎诊断16例、合并有基础疾病或并发症54例；(2)检出病原体中细菌占90，8％：其中G^-杆菌占59．8％、G^ 球菌占31．0％，真菌占9．2％；(3)有效率89％、死亡率11％。结论：革兰氏阴性杆菌是急诊肺炎主要的致病菌，对传统第一线抗生素多耐药，大多对合成抗生素和广谱抗生素较敏感：影响急诊肺炎预后的主要因素是延误就诊时间、抵抗力下降、院外抗生素滥用、敏感菌株减少以及基础疾病严重程度。

Clinic Observation on Emergence Patients with Pulmonary Infection and Antibiotic Therapy

Objective:To understand pathogen distribution and the sensitivity to antibiotic therapy and the factors effecting. Methods:70 patients with pulmonary infection at the emergency centre from 2001.11 to 2003.10 were retrospectively analyzed. Result: (1)16 cases of only pulmonary diagnose, 54 cases of underlying disease; (2)90.8% of bacteria in pathogen though examination, in which 59.8% gram-negative bacteria, 31.0% gram-positive bacteria,9.2% fungi; (3)effective rate was 89%,death rate was 11.9%. Conclusions: It revealed that the pathogen of patients was dominated by gram-negative bacteria. Antibiotic sensitivity test showed that the resistance of pathogen to traditional first antibiotics was increased. Synthetic and broad-spectrum antibiotics were more sensitive. The prognosis main factor of affecting emergence pulmonary infection is the delay of treatment, the decline of resistance, the misuse of community antibiotics, the decrease of bacteria sensitivity and the seriousness of underlying disease.