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目的:观察老年患者社区获得性肺炎(CAP)的临床及治疗现况。方法:连续入选2007年9月至2010年5月在我院呼吸科住院治疗的CAP患者432例,记录临床特点、基础疾病、并发症、病原学和治疗情况,分析年龄≥65岁与非老年患者的差异。结果:432例CAP患者中,老年人共136例(31.4%),与非老年患者比较,老年CAP患者并存基础疾病多(P<0.01)、易发生神志障碍(20%比6%,P<0.01)、呼吸衰竭(18%比7%,P<0.01)和休克(15%比7%,P<0.01);与非老年患者比较,老年CAP患者革兰阴性杆菌发生率更高(63.6%比41.6%,P<0.01),抗生素选用碳青酶烯类更多,联合用药抗感染多;老年CAP患者住院时间比非老年患者长,治疗费用也更多。结论:老年CAP患者具有并存疾病多,易发展为重症且治疗更复杂、更困难的特点。
Objective: To observe the clinical and treatment status of community-acquired pneumonia (CAP) in elderly patients. Methods: A total of 432 patients with CAP admitted to Department of Respiratory Medicine in our hospital from September 2007 to May 2010 were enrolled. The clinical features, underlying diseases, complications, etiology and treatment were recorded. The patients aged ≥65 years and non-elderly Patient differences. Results: Of the 432 CAP patients, 136 (31.4%) were elderly patients. Compared with non-elderly patients, elderly patients with CAP had more underlying diseases (P <0.01), and were susceptible to delirium (20% vs 6%, P < 0.01), respiratory failure (18% vs 7%, P <0.01) and shock (15% vs 7%, P <0.01). Compared with non-elderly patients, the incidence of gram- More than 41.6%, P <0.01). More antibiotics use more carbo-alcholes and more anti-infectives in combination. Elderly CAP patients have longer hospital stay and longer treatment costs than non-elderly patients. Conclusion: Elderly patients with CAP have co-morbidities, easy to develop severe disease and more complex and difficult to treat.