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目的探讨老年人肺炎的临床特征,提高老年人肺炎的诊治水平。方法以我科收治的2 4 2例老年肺炎患者为分析对象,对其临床特点、诊断方法、治疗及转归进行回顾性分析,总结经验。结果本组242例患者,仅半数有呼吸道症状和体征,且有72.7%的患者合并有其他基础疾病。胸部CT检查诊断率高,患者平均住院时间为10.2d,痊愈92例(38.1%),好转100例(41.3%),死亡13例(5.4%),无效37例(15.3%),有效率为79.3%。结论老年人肺炎临床表现不典型,合并多种慢性疾病,病情复杂,容易被漏诊、误诊。所以首诊医生要提高认识,全面检查,明确诊断的同时,必须综合治疗,坚持用药的个体化,正确使用抗生素是治疗成功的关键。
Objective To investigate the clinical features of pneumonia in the elderly and to improve the diagnosis and treatment of pneumonia in the elderly. Methods A total of 224 cases of elderly patients with pneumonia treated in our department were analyzed. The clinical features, diagnosis, treatment and prognosis were retrospectively analyzed and the experience was summarized. Results 242 patients in this group, only half of the respiratory symptoms and signs, and 72.7% of patients with other underlying diseases. The diagnostic rate of chest CT was high. The average length of stay was 10.2 days. The recovery rate was 92 cases (38.1%), 100 cases (41.3%) were improved, 13 (5.4%) died and 37 (15.3%) were ineffective. The effective rate was 79.3%. Conclusion The clinical manifestations of pneumonia in the elderly are not typical, with a variety of chronic diseases, the condition is complicated, easily missed diagnosis, misdiagnosis. Therefore, the first doctor to raise awareness, a comprehensive examination, a clear diagnosis, we must comprehensive treatment, adhere to the individual medication, the proper use of antibiotics is the key to the success of treatment.