肺部感染诱发老年多器官功能衰竭临床分析

目的　探讨由肺部感染诱发老年多器官功能衰竭 (MOEF)的临床特征 ,提高其救治水平。方法　对 2 4例肺部感染所致MOEF患者致病菌、临床表现、器官衰竭发生规律、X线特征及救治方法进行分析。结果　老年肺部感染以院内获得性居多 ,病原菌中以甲型链球菌、克雷伯氏杆菌、铜绿假单胞杆菌、阴沟杆菌及肺炎球菌多见 ,且极易诱发MOEF ;金黄色葡萄菌感染死亡率最高。病死率与年龄、基础疾病、病程呈正相关 ,与肺部感染到出现MOEF的时间负相关。合并消化道出血和碱中毒者预后不佳。结论　老年人肺部感染症状多不典型 ,应重视肺部感染所启动MOEF具有预警价值的痰培养、动脉血气分析和X线等方面检查 ;在重视救治的同时 ,更应强调预防的重要性。

Clinical Analysis of Senile MOEF Induced by Pulmonary Infection

Objective To study the clinical characteristics of senile MOEF induced by pulmonary infection so as to provide better treatment.Methods Analysis was given to the pathogens,clinical manifestation,the occurrence of MOEF,the X-ray specialties and treatment of 24 cases of MOEF induced by pulmonary infection.Results Most of the senile pulmonary infection were acquired in hospital,the pathogenic bacteria were mainly Streptococcus A,Klebsiella pneumoniae,Pseudomonas aeruginosa,Enterobacter cloacae,and Pneumococcus,which were easy to induce MOEF;Infection with Staphylococcus aureus led to the highest death rate.The fatality rate was positively related with age,basic diseases and the course of diseases,and is negatively related with time from pulmonary infection to the occurrence of MOEF.Prognosis was not satisfied if complicated with hemorrhage of digestive tract and alkalosis.Conclusions The symptoms of senile pulmonary infection are often not so typical that attention should be given to such examinations as sputum culture,blood gas analysis and X-ray examination.Besides treatment,the importance of prevention should be further stressed.