维持性血液透析患者合并社区获得性肺炎46例临床分析

摘要

目的：探讨维持性血液透析患者合并社区获得性肺炎的发生率、相关的危险因素及防治措施.方法：回顾性分析上海浦东医院肾内科2007年8月-2012年5月确诊为维持性血液透析患者合并社区获得性肺炎的46例患者的临床资料，分析其危险因素及诊治情况.结果：维持性血液透析患者共137例，其中合并社区获得性肺炎46例，比例为33.6%，男25例，女21例，平均年龄(61.3±12.8)岁，治疗后好转和痊愈43例，死亡3例.肺炎组的年龄、糖尿病比例明显高于非肺炎组(P<0.05).肺炎组的血清白蛋白、血红蛋白浓度高于非肺炎组，差异有统计学意义(P<0.05).结论：维持性血液透析患者由于多种原因，极易发生社区获得性肺炎，特别是重症肺炎，死亡率明显增加.年龄、糖尿病、低蛋白血症、血红蛋白水平、透析不充分是维持性血液透析患者合并社区获得性肺炎的危险因素，应该引起重视并及时防治.%Objective:To investigate the incidence,risk factors and prevention measures with maintenance hemodialysis patients complicated with community acquired pneumonia simultaneously.Methods:We retrospectively analyzed the clinical data of 46 patients with maintenance hemodialysis complicated with community acquired pneumonia from August 2007 to May 2012 in our department.The risk factor and treatment of patients with maintenance hemodialysis complicated with community acquired pneumonia were analyzed.Results:A total of 137 cases in maintenance hemodialysis patients,which merged 46 patients with community acquired pneumonia,the proportion was 33.6%,male 25 cases,female 21 cases,average age (63.3±12.8)years,improved and recovered after treatment in 43 cases,3 deaths.The age,diabetes were significantly higher in pneumonia group than which in non pneumonia group(P<0.05).The serum albumin,hemoglobin concentration were higher than which in pneumonia group,there was significant difference(P<0.05).Conclusion:Hemodialysis patients due to various reasons,prone to community acquired pneumonia,especially severe pneumonia,mortality significantly increased.Age,diabetes,hypoalbuminemia, hemoglobin level,inadequate dialysis are risk factors in maintenance hemodialysis patients complicated with community acquired pneumonia,should pay attention to the prevention and timely.