167例（191例次）慢性肺心病临床资料分析

目的 :探讨肺心病急性发作期的病原学、抗生素的选择、酸碱失衡类型、机械通气以及死亡原因等问题。方法 :对 1999- 0 1- 0 1/ 1999- 12 - 31收治的住院肺心病患者 16 7例 (191例次 )的临床资料进行分析。结果 :肺心病患者肺功能以中、重度损害为主 ;院外社区感染以革兰氏阳性球菌多见 ,而医院内获得性感染则主要以革兰氏阴性杆菌为主 ,其中假单胞菌、不动杆菌和肠杆菌属为最多见 ,金黄色葡萄球菌、嗜麦芽黄单胞菌的发病率有所提高 ,并对多种抗生素耐药 ;酸碱失衡类型中 ,呼吸性酸中毒占首位 ;抗生素的选择以左旋氧氟沙星、氨苄青霉素 /舒巴坦最为多见 ;死亡原因中呼吸衰竭占首位。讨论 :对慢性肺心病患者应定期进行肺功能检查 ,并进行综合治疗 ,以减少并发症 ,改善预后。

Clinical Analysis of 167 Cases with Chronic Pulmonary Heart Disease

Objective:To discuss the clinical feature of chronic pulmonary heart disease.Methods:To review 167 cases with pulmonary heart disease in 1999,and determine the problems of lung function,bacteriology,mechanical ventilation,acidbase unbalance,reasons of death et al.Results:Moderate and svere damage of lung function are primary in patients with chronic pulmonary heart disease.Community acquired infection is dominated by G cocci,and G - bacilli is the main pathogens in hospitalized acquired infection.Bacterium aeruginosum,bacterium coli and staphylococcus aureus play an important role in lung infection,and the high drug resistance in many strains.The chief type of acid base unbalance is respiratory acidosis.Ampicillin and levofloxacin are popularly used in treating infection.Respiratory failure is the first reason of death in patients with pulmonary heart disease.Conclusion:Ought to examine palmonary function regularly of patients with pulmonary heart disease,and treat them synthetically.Thus it can reduce complications and improve the prognosis.