老年人医院获得性革兰阴性杆菌肺炎120例临床分析

目的：分析老年人医院获得性革兰阴性杆菌肺炎的临床特点，诊断与治疗。方法：回顾性调查本院1996年1月-2002年10月期间120例革兰阴性杆菌肺炎老年患者的病原菌种类、治疗效果。结果：120例痰培养革兰阴性杆菌阳性标本中，单一菌79例（占65.8%)。复数菌或二重感染41例（占34.2%)，病原菌主要以铜绿假单孢菌、不动杆菌、肺炎克雷伯菌、大肠埃希菌为主。治疗有效率74.2%(89/120)，病死率17.5%。结论：为了有效防止医院感染，应努力做到：患者尽量采取半卧位，加强口腔护理，医护人员洗手避免交叉感染，严格病房空气和用具定时消毒和隔离制度。正确使用抗生素和免疫抑制剂；及时检测病原菌，提高患者的自身免疫功能。

Clinical Analysis of 120 Cases of Nosocomial Pneumonia of Gram-negative Bacilli of the Elderly

Objective: To study the clinical characteristics, diagnosis and treatment of nosocomial pneumonia (NP) of gram negative bacilli of the elderly. Methods: Investigate retrospectively the pathogenic types and the clinical efficacy of 120 cases of NP of gram negative bacilli of the elderly from 1996.1 2002.10. Results: In the 120 cases, the incidence of NP of single pathogen was 65.8%(79/120), while dual infection was 34.2%(41/120). The pathogenic bacteria were Pseudomonas aeruginosa, Acinetobacter species, Klebsiella pneumoniae, and Escherichia coli. The therapeutic efficacy rates were 74.2%. The death rates were 17.5%. Conclusion: In order to prevent NP, some measures should be taken. (1)Patients should take half prone position and intensify oral cavity cleaning,and the staff should wash hands to prevent cross infection. (2)Strict observance of the regulation of isolation and regular sterilization of the ward air and instruments. (3)Selection of antibiotics and immunosuppression reasonably. (4)Inspection of pathogen in time. (5)Elevation of patients' immune function.