老年人社区获得性肺炎临床分析

目的：分析老年人社区获得性肺炎的临床特点及流行病学特征。方法：对上海市宝山区25家医院3502例老年人社区获得性肺炎患者的临床资料进行回顾性分析。结果：年龄60～105（75.03±8.42）岁,男性1831例（52.3%）,女性1671例（47.7%）。冬春季节发病2406例（68.7%）,夏秋季发病1096例（31.3%）。发热1578例（45.1%）,咳嗽或咳痰1986例（56.7%）,乏力伴纳差2001例（57.1%）。血白细胞数升高（≥10×109/L）708例（20.2%）,白细胞数正常而中性粒细胞升高1209例（34.5%）,白细胞数减少（≤4×109/L）88例（2.5%）,两者均正常1497例（42.7%）。双肺肺炎996例（28.4%）,左肺肺炎913例（26.1%）,右肺肺炎1593例（45.5%）。合并基础疾病1935例（55.3%）,出现并发症518例（14.8%）。患者住院天数8～47（18.3±2.4）d。住院费用为人民币1865～9892（4823.36±251.24）元。死亡291例（9.3%）。结论：老年人社区获得性肺炎临床表现不典型,双肺病变多见,合并基础疾病及并发症多,住院时间长,医疗费用较高。

Clinical Analysis of Community Acquired Pneumonia in the Elderly Patients

Objective：To study the clinical and epidemic characteristics of community acquired pneumonia（CAP） in the elderly patients. Methods：Retrospective analysis was used to analyze The clinical data of 3 502 elderly patients with CAP from 25 hospitals in Baoshan District of Shanghai was analyzed retrospetively. Rexults：Age was from 60 to 105 （75.03 ± 8.42）. There were 1 831 （52.3% ） male and female 1 671 （47.7% ）, 2 406 cases （68.7 % ） in winter and spring, 1 096 cases（31.3 %） in summer and autumn. 1578（45.1% ） cases had fever, 1 986 （56.7% ） had cough and expectoration, 2 001（57.1% ） had fatigue and ano- rexia. White blood cells increased in 708 （20.2%） cases, neutrophil increased in 1 209 （34.5 % ） cases, both were normal in 1497（42.7%） cases. 996（28.4%） cases had double pneumonia,913（26.1%） had left pneumonia,and 1 593（45.5%） had right pneumonia. 1935 cases （55.3%） were accompanied with other diseases, 518 patients（14. 8%）developed complications. The mean hospitalization duration was 18.3±2.4 days and expense 4823.36± 251.24 RMB. 291 cases （9.3%） died during treatment,Conclusion：Symptoms and signs of CAP in the elderly were atypical. It is more often for them to have double pneumonia and be accompanied with other diseases or complications . Hospitalization duration of them was long,and expense was high.