摘要
目的 分析成人社区获得性肺炎(CAP)患者早期治疗失败的原因.方法 回顾性分析2002年1月至2008年1月我院呼吸内科收治的成人CAP患者的临床资料,总结早期治疗失败的发生率及其对CAP患者预后的影响.比较老年CAP患者(年龄>65岁)与年轻CAP患者(年龄≤65)导致早期治疗失败原因的异同.结果 成人CAP患者549例,年龄(61±23)岁,年轻患者208例,老年患者421例.住院病死率为10.2%.共计68例(12.4%)患者出现早期治疗失败.根据原因分类,其中诊断错误9例(13.2%),宿主相关因素25例(36.8%),肺炎相关因素27例(39.7%)和不明原因7例(10.3%).相对年轻CAP患者,宿主相关因素导致的早期治疗失败在老年CAP患者中更常见(P＝0.002).而年轻CAP患者中,早期治疗失败主要与肺部相关因素有关(P＝0.005).结论 早期治疗失败会增加CAP患者病死率及延长平均住院时间.在临床工作中及早认识并预防早期治疗失败的出现,对于改善CAP患者预后具有重要意义.
Objective To determine the incidence and causes associated with early failure in hospital patients with community-acquired pneumonia(CAP). Methods A retrospective cohort analysis was performed for adult patients hospitalized with CAP between Jan.2002 and Jan.2008. The impact of early failure on the prognosis of patients with CAP was evaluated. Differences in causes of early failure between≤65 years and >65 years groups were calculated using χ2 test. Results A total of 549 patients (208 younger and 341 elderly patients) were enrolled with a mean age of (61±23)years. Mean hospital stay was 11 days and in-hospital fatality was 10.2%. As a result, 68 cases (12.4%) presented early failure within 72 h of admission. Most causes of early treatment failure could be attributed to host-related factors (36.8%) and pneumonia-related factors (39.7%). As compared, host-related factors were more important causes for elder patients and pneumonia-related factors were more common in younger patients. Conclusions Early treatment failure is associated with high fatality rate and longer of hospital stay. Its detection and management require careful clinical assessment.
出处
《中国实用医刊》
2010年第18期28-31,共4页
Chinese Journal of Practical Medicine
关键词
社区获得性肺炎
治疗失败
Community-acquired pneumonia
Treatment failure
