COPD急性加重期并发医院获得性肺炎51例临床分析

目的探讨慢性阻塞性肺疾病急性加重期（Acute exacerbation of chronic obstruetive pulmonary disease，AECOPD）发生医院获得性肺炎（Hospital-acquired pneumonia，HAP）的特点及高危因素，预防HAP的发生。方法对51例AECOPD并发HAP患者的临床资料进行回顾性分析。结果AECOPD患者并发HAP住院时间明显延长，死亡率增加，老年患者及有基础疾病或合并症者发生率增加，其感染病原菌以革兰阴性菌为主，混合感染常见。结论AECOPD并发HAP使患者住院时间延长，死亡率增加。在积极治疗原发病的同时，应注意基础疾病及合并症的治疗，应根据药物敏感试验合理选用抗菌药物，在获得药物敏感试验结果前应根据可能的病原菌经验性用药。

Clinical analysis of 51 patients of AECOPD combined hospital-acquired pneumonia

Objective To investigate the patients of acute exacerbation of chronic obstructive pulmona- ry disease（AECOPD） occurrence of hospital-acquired pneumonia（HAP） characteristics and risk factors, prevention of the occurrence of HAP. Methods 51 cases of AECOPD concurrent HAP were retrospectively analyzed. Results AECOPD patients concurrent HAP hospital stay was significantly prolonged, increased mortality. For elderly patients and patients with underlying diseases or complications, HAP increased incidence., infection pathogens mainly Gram-negative bacteria, mixed infection was common. Conclusion AECOPD compli- cated by HAP to extend the patient＇ s hospital stay, and increased mortality. While in the active treatment of the primary disease, should pay attention to the underlying disease and complications of treatment, rational use of antimicrobial drugs should be based on the drug sensitivity test, before this empiric medication according to the pathogens.