Clinical Analysis Of Aspiration Pneumonia In 110 Cases

Objective: To investigate risk factors ,clinical features ,etiology of inhalation pneumonia. The purpose of this study is to provide evidence for clinical diagnosis .Methods: Totally 110 cases of inhalation pneumonia during from June 2007 to september 2010 were completely surveyed and analyzed. Separated the cases for two groups,for community acquired pneumonia and hospital acquired pneumonia. obtained the clinical data by retrospective research.Using Excel software statistics,and SPSS17.0 data analysis.Results:1. General informations CAP 65 cases ,HAP 45 cases.The age between 47-96, mean value was (75±8.55).There were 95 (86.36%)cases age greater than 65. Male 82 cases, Female 28 cases . Length of Stay were between 2d and 153d.2.Distribution of underlying diseases Cerebral hemorrhage 25 cases(22.72%),cerebral infarction 38 cases(34.54%),Traumatic brain injury,Intracranial space occupying lesion 6 cases(5.45%),Parkinson's disease 14 cases(12.72%),Brain atrophy 32 cases(29.09%),Diabetes 13 cases(11.81%),hypertension 57cases(57%),Heart disease 19 cases(17.27%),Cancer 5 cases(4.54%),Fracture 4 cases(3.63%). To combine other risk factors Tracheal cannula or incision of tracheal 30 cases(27.27%)Indwelling nasogastric tube 43 cases(39.09%),Lying in bed(the time of lying in bed>1month)75cases(68.18%).3.Clinical manifestations symptom fever 84 cases(76.36%), cough 67 cases (60.9%), Increased sputum 82 case(s74.54%),Purulent sputum 55case(s50%), White sticky sputum 27 cases(24.55%), dyspnea 39 cases(35.45%), lethargy \ Anorexia \ Fatigue,and without Respiratory symptoms 25 cases(22.72%);signs diminished breath sound 6 cases,moist rale 76cases(69.09%), dry rale 3 cases(2.72%),both moist and dry rale 18 cases(16.36%).4.characteristics of iconography Chest X ray or chest CT: Bilateral lesions 83 cases;Unilateral lesions 27 cases, the lesion of right side 15 cases, the lesion of left side 12 cases.5.chemical examination WBC>10×109/L or <4×109/L 61 cases;GR%>70% 89 cases.blood gas analysis :Ⅰrespiratory failure 48 cases;Ⅱrespiratory failure 6 cases;hyoxemia 20 cases;normal 36 cases.6.pathogenic bacteria 80 cases (72.72%) at least cultivated one pathogen,64 cases (58.18%)cultivated more than two pathogens.Totally 220 pathogens were isolated from sputa.There were 169 strains of Gram-negative bacillus,klebsiella pneumoniae 26 strain,Pseudomonas aeruginosa 46 cases , Acinetobacter baumanni 49 cases, and other Acinetobacter 6 cases, Escherichiacoli 4 cases, Stenotrophomonas maltophilia10 cases, Serratieae 12 cases,Enterobacter cloacae 3 cases,Haemophilus influenzae 2 cases, bacterium alkalescens 4 cases,Meningitis flavobacterium 3 cases,alcaligenes faecalis; 2 cases,Pseudomonas putida 2 cases.41strains of Gram-positive cocci,streptococcus pneumoniae 2 cases,Staphylococcus aureus 36 cases,among the total methicillin resistant staphylococcus aureus 28 cases,Coagulase-negative staphylococci 3 cases.10 strains of fungi,among the total Candida albicans 4 cases,Candida tropicalis 1 cases, Candida krusei 2 cases,Saccharomycopsis 3 cases. Grouping these cases for tow groups, one is CAP,the other is HAP. Take chi-square test,α=0.05, result P<0.05。Conclusions: As the literature report, aspiratioon pneumonia is very common in clinical, the incidence rate were higher in the aged,and have not typical in their clinical signs and symptoms.Most patient have risk factors . The more risk factors, the more incidence. No matter CAP or HAP,the major pathogenic bacteria were Gram-negative bacillus. But there were disparations between them.Make rational use of antibiotic.