目的探讨老年人院内获得性肺炎(HAP)的临床、病原学特点、易患因素及防治对策.方法对36例老年HAP患者进行回顾性分析.结果36例老年HAP患者的临床表现不典型,病原菌主要以G-杆菌为主,占71.1%;同时两种细菌或细菌和真菌的混合感染严重,占46.2%.革兰氏阴性菌主要对头孢哌酮、头孢他啶、泰能、氧哌嗪青霉素、环丙沙星、丁胺卡那霉素敏感;而G+主要是金黄色葡萄球菌,主要对万古霉素敏感.结论老年人生理功能的退变,机体抵抗力低下,合并慢性基础疾病,营养不良、肺功能低下,同时反复大量使用多种抗生素,是造成HAP的主要危险因素;增强免疫功能、加强营养及病房的空气消毒是主要的防治措施.%Objectiye: To investigate clinical and etiological characteristics, predisposing factors of hospital-acquired pneumonia (HAP) in senile people and to explore the preventive and therapeutic strategies.Methods: 36 elderly cases with HAP were retrospectively analyzed. Results: The clinical features of HAP in the elderly were atypical. The pathogens were chiefly G- bacilli (accounting for 71.1%) while mixed infections of two bacteria or bacterium and fungus were also common (46.2%). The G- bacilli were mainly sensitive to Cefoperazone, Ceftazidime, Tienam, Piperacillin, Ciprofloxacin and Amikacin. The G+ bacterium was mainly Staphylococcus aureaus that was sensitive to Vancomycin. Conclusions: Degeneration of physiological function,decreased body resistance, accompanying chronic diseases, malnutrition, reduced pulmonary function and abuse of antibiotics are the main risk factors for HAP in the elderly. Improvement of immune function, adequate nutrition and air sterilization in the wards are the central strategies for prevention and treatment.
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