袁鑅,童建菁,叶静,陆一鸣,徐星萍.高龄卫生保健相关性肺炎患者的临床特点和护理讨论[J].上海护理,2017,17(7):
高龄卫生保健相关性肺炎患者的临床特点和护理讨论
DOI:
中文关键词:  高龄  社区获得性肺炎  卫生保健相关性肺炎  护理干预
英文关键词:Elderly  Community acquired pneumonia  Healthcare associated pneumonia  nursing interventions
基金项目:
作者单位E-mail
袁鑅 上海交通大学医学院附属瑞金医院特需医疗保健中心 bronte_yuan1201@163.com 
童建菁 上海交通大学医学院附属瑞金医院特需医疗保健中心  
叶静 上海交通大学医学院附属瑞金医院急诊科  
陆一鸣 上海交通大学医学院附属瑞金医院急诊科  
徐星萍* 上海交通大学医学院附属瑞金医院特需医疗保健中心 xxp20291@rjh.com.cn 
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中文摘要:
      目的 探讨高龄卫生保健相关性肺炎(HCAP)患者的临床特征和护理特点。方法 对2012年1月至2013年12月急诊病房收治的年龄>80岁的高龄肺部感染患者的临床资料进行回顾性分析,比较社区获得性肺炎(CAP)组和卫生保健相关性肺炎(HCAP)组患者的临床特征、病原学特点及预后。结果 165例高龄肺部感染患者中,HCAP组患者的平均住院天数(19.9 d)显著长于CAP组(14.6 d)(P<0.05),且病死率显著高于后者(22.9% 比 7.3%,P<0.05)。HCAP组患者入院时的肺炎严重度指数(PSI)显著高于CAP组(125.2 比 116.8,P<0.05),PSI评分Ⅴ级的比例也显著高于后者(38.6% 比 23.2%,P<0.05)。结论 高龄肺部感染患者基础疾病多,营养状况差,临床症状不典型,特别是HCAP患者入院时病情重,住院时间长,病死率高,早期诊断治疗和护理干预具有重要的临床意义。
英文摘要:
      Objective To analysis the clinical and nursing characteristics of elderly patients with healthcare associated pneumonia (HCAP) in emergency department. Methods The clinical material of elderly patients with pneumonia were analyzed retrospectively in our emergency ward from Jan 2012 to Dec 2013. over 80-year-old pneumonia were divided into 2 groups[community acquired pneumonia(CAP) and HCAP].The characteristics of clinical,pathogen and outcome were compared. Results In 165 cases,the average hospital stay length of HCAP was significantly longer than that of CAP(19.9 d vs 14.6 d, P<0.05)and the mortality of HCAP was significantly higher than that of CAP(22.9% vs 7.3%, P<0.05). The pneumonia severity index(PSI) and the proportion of Class Ⅴ of HCAP were also significantly higher than that of CAP (125.2 vs 116.8 and 38.6% vs 23.2%, P<0.05).Conclusions The characteristics of elderly patients with pneumonia are more underlying disease,malnutrition and untypical clinical feature those are associated with high PSI on admission, longer of hospital stay and high mortality especially in HCAP. Early diagnosis, treatment and nursing interventions have important clinical significance.
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