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《非hiv感染免疫抑制患者重癥肺炎的臨床特點(diǎn)及預(yù)后相關(guān)危險(xiǎn)因素分析》由會(huì)員上傳分享,免費(fèi)在線閱讀,更多相關(guān)內(nèi)容在學(xué)術(shù)論文-天天文庫(kù)。
1、授予單位代碼10089學(xué)號(hào)或申請(qǐng)?zhí)?0153117中國(guó)圖書分類號(hào)R563.1HebeiMedicalUniversity碩士學(xué)位論文專業(yè)學(xué)位非HIV感染免疫抑制患者重癥肺炎的臨床特點(diǎn)及預(yù)后相關(guān)危險(xiǎn)因素分析研究生:顧瑩導(dǎo)師:潘文森教授專業(yè):內(nèi)科學(xué)二級(jí)學(xué)院:河北醫(yī)科大學(xué)第二醫(yī)院2018年3月目錄中文摘要················································································1英文摘要·································
2、···············································2英文縮寫················································································4研究論文非HIV感染免疫抑制患者重癥肺炎的臨床特點(diǎn)及預(yù)后相關(guān)危險(xiǎn)因素分析前言················································································6材料與方法···········
3、····························································7結(jié)果················································································8附圖··············································································12附表········································
4、······································15討論··············································································20結(jié)論··············································································27參考文獻(xiàn)····························································
5、············27綜述非HIV感染免疫抑制患者的肺炎········································32致謝·····················································································47個(gè)人簡(jiǎn)歷··············································································48中文摘要非HIV感染免疫抑制患者重癥肺炎的臨
6、床特點(diǎn)及預(yù)后相關(guān)危險(xiǎn)因素分析摘要目的:分析非HIV感染免疫抑制患者重癥肺炎的臨床特點(diǎn)及預(yù)后相關(guān)危險(xiǎn)因素,為臨床診治提供參考。方法:選取收治河北醫(yī)大二院呼吸二科重癥監(jiān)護(hù)病房中101例非HIV感染免疫抑制并發(fā)重癥肺炎患者。根據(jù)患者入院后28d病情轉(zhuǎn)歸情況分為存活組和死亡組。對(duì)比分析兩組患者入院一般情況及臨床資料,并進(jìn)行危險(xiǎn)因素分析。結(jié)果:1兩組患者性別、年齡、體重指數(shù)、住院時(shí)間、臨床癥狀、72小時(shí)內(nèi)液體正平衡人數(shù)、肺泡灌洗液中細(xì)胞學(xué)分類、基礎(chǔ)疾病及激素和(或)免疫抑制劑治療情況均無(wú)明顯差異(P>0.05)。2影像學(xué)表現(xiàn)以雙肺浸潤(rùn)為主,
7、累及間質(zhì)性質(zhì)的病變較多,死亡組氣胸及縱隔氣腫患者死亡率較高(P<0.05)。3感染病原體菌譜廣,多重耐藥菌及機(jī)會(huì)性感染幾率高,死亡組多重耐藥細(xì)菌感染患者多于存活組(P<0.05)。4患者病情重,其中死亡組APACHEII評(píng)分、hsCRP、NEUT%較高(P<0.05),LY、CD3+和CD4+細(xì)胞絕對(duì)計(jì)數(shù)及百分比較低(P<0.05),最終需要行有創(chuàng)機(jī)械通氣患者比例較高(P<0.05)。結(jié)論:1死亡組APACHEII評(píng)分、hsCRP、NEUT%較高,LY、CD3+和CD4+細(xì)胞絕對(duì)計(jì)數(shù)及百分比較低,多重耐藥細(xì)菌感染及發(fā)生呼吸機(jī)所致肺
8、損傷人數(shù)較多,需行有創(chuàng)機(jī)械通氣率較高。2Logistic回歸分析顯示需行有創(chuàng)機(jī)械通氣、發(fā)生呼吸機(jī)所致肺損傷是影響非HIV感染免疫抑制患者重癥肺炎預(yù)后的獨(dú)立危險(xiǎn)因素。關(guān)鍵詞:重癥肺炎,非HIV感染免疫抑制,危險(xiǎn)因素,重癥監(jiān)護(hù)病房,有創(chuàng)機(jī)械通氣,呼吸機(jī)