摘要
目的确定病原体对于社区获得性肺炎(community acquired pneumonia,CAP)的诊疗具有重要价值。通过探讨细菌性与病毒性CAP临床症状及缺氧状态的差异,对CAP的病因做出初步判断,可以减少误诊和漏诊,指导CAP临床诊疗工作。本研究对比分析细菌与病毒性CAP临床症状及缺氧程度。方法选择2017-11-01-2020-01-01兴山县人民医院诊断为细菌性或病毒性CAP并住院治疗、符合纳入标准的2145例患者作为研究对象,通过筛查病历中的主诉、现病史、既往史、诊断和相关检查结果,将2145例患者根据CAP病原诊断分为细菌性CAP组(714例)和病毒性CAP组(1431例)。分析两组临床症状(体温、咳嗽咯痰、胸闷、嗜睡、呼吸困难和意识模糊)及动脉血气分析的差异。结果两组体温(χ2=269.0,P<0.001)和主要临床表现(χ2=115.8,P<0.001)比较,差异有统计学意义。病毒性CAP组二氧化碳分压为(45.4±9.6)mm Hg,高于细菌性CAP组的(40.2±7.1)mm Hg,t=12.830,P<0.001;氧分压为(62.4±11.5)mm Hg,低于细菌性CAP组的(70.2±10.3)mm Hg,t=15.321,P<0.001;血氧饱和度为(85.3±7.6)%,低于细菌性CAP组的(91.2±5.3)%,t=18.610,P<0.001;氧合血红蛋白为(75.2±8.9)%,低于细菌性CAP组的(80.4±7.4)%,t=13.460,P<0.001;实际碳酸氢盐为(35.3±6.6)mmol/L,高于细菌性CAP组的(32.5±5.7)mmol/L,t=9.677,P<0.001。结论细菌性CAP高热及超高热的发生率更高;病毒性CAP胸闷、呼吸困难症状发生的比例更高,缺氧程度更高。
OBJECTIVE It is of great value for the diagnosis and treatment of community acquired pneumonia(CAP)to determine the pathogen.By exploring the difference between the clinical symptoms and anoxia status of bacterial cap and viral cap,we can make a preliminary judgment on the cause of cap,reduce misdiagnosis and missed diagnosis,and guide the clinical diagnosis and treatment of cap.In this study,the clinical symptoms and hypoxia degree of bacterial and viral community-acquired pneumonia were analyzed.METHODS By retrospective study,the patients diagnosed as bacterial or viral cap in Xingshan County People’s Hospital from November 1,2017 to January 1,2020 were included in the study.The 2145 patients who met the inclusion and exclusion criteria were divided into bacterial cap group 714 and viral cap group 1431 according to the etiological diagnosis of cap by screening the main complaint,current history,past history,diagnosis and related examination results in the medical record.The differences of clinical symptoms(body temperature,cough,expectoration,chest distress,drowsiness,dyspnea,blurred consciousness)and arterial blood gas analysis between the two groups were analyzed.RESULT There was significant difference in body temperature(χ2=269.0,P<0.001)and main clinical manifestations(χ2=115.8,P<0.001)between the two groups.The CO2 partial pressure of viral cap group was(45.4±9.6)mm Hg,higher than that of bacterial cap group(40.2±7.1)mm Hg,t=12.830,P<0.001.The O2 partial pressure of viral cap group was(62.4±11.5)mm Hg,lower than that of bacterial cap group(70.2±10.3)mm Hg,t=15.321,P<0.001.Blood oxygen saturation of viral cap group was(85.3±7.6)%,lower than that of bacterial cap group(91.2±5.3)%,t=18.610,P<0.001.Oxyhemoglobin of viral cap group was(75.2±8.9)%,lower than that of bacterial cap group(80.4±7.4)%,t=13.460,P<0.001.Actual bicarbonate of viral cap group was(35.3±6.6)mmol/l,higher than that of bacterial cap group(32.5±5.7)mmol/l,t=9.677,P<0.001.CONCLUSION The incidence of bacterial cap high fever and super high fever is higher,the incidence of viral cap chest tightness and dyspnea is higher,and the degree of hypoxia is higher.
作者
向常娥
王芳
XIANG Chang-e;WANG Fang(Department of Respiratory and Critical Care Medicine,Xingshan County People's Hospital,Xingshan443700,P.R.China)
出处
《社区医学杂志》
2020年第17期1226-1229,共4页
Journal Of Community Medicine
关键词
社区获得性肺炎
细菌性
病毒性
临床症状
动脉血气分析
community acquired pneumonia
bacterium
viral
clinical symptoms
arterial blood gas analysis
作者简介
通信作者:向常娥,女,湖北兴山人,主治医师,主要从事呼吸系统疾病诊治的临床研究工作。E-mail:ychaodaifu@163.com
