pneumoniae pneumonia
Introduction
Introduction to pneumonia pneumonia Klebsiella pneumoniae (Klebsiella pneumoniae), Klebsiella pneumoniae is an acute lung inflammation caused by Klebsiella pneumoniae, more common in old age, malnutrition, chronic alcoholism, chronic bronchial-pulmonary disease and whole body Depleted patients. The onset is sharp, with high fever, cough, sputum and chest pain. There may be purpura, shortness of breath, heart palpitations, about half of the patients have chills, early shock. basic knowledge The proportion of illness: 0.0002% Susceptible people: more common in the elderly Mode of infection: contagious Complications: septic shock cerebral palsy
Cause
Cause of pneumococcal pneumonia
Bacterial infection (85%):
The pathogen of this disease is Klebsiella. Klebsiella pneumoniae is highly pathogenic to humans and is one of the important conditional pathogens and iatrogenic infections.
Prevention
Pneumonia pneumonia prevention
1. Strictly implement the disinfection and isolation system. This is mainly for medical staff and the hospital environment and equipment. Before and after contact with patients, strict hand washing and glove operation, regular environmental and indoor disinfection and ventilation, regular cleaning and disinfection of respiratory treatment devices according to requirements, regular Replace the mechanical ventilation and nebulizer piping, etc., and adopt a set of strict in-hospital infection monitoring and prevention programs. According to reports, the hospitals taking this plan have a lower infection rate of 20% compared with the untaken hospitals.
2, gastrointestinal decontamination treatment This is a commonly used preventive measure in Europe, mainly for the susceptible population of nosocomial infection, the purpose is to remove colony colonization and growth in the gastrointestinal tract. The method has a total gastrointestinal decontamination and selective gastrointestinal decontamination method, the latter is commonly used, which is by nasal feeding or oral gastrointestinal non-absorbed polymyxin B, tobramycin (gentamicin or new mold)) and amphotericin B, for 5 days, and daily application of cephalosporin, remove aerobic bacteria from the oropharynx and gastrointestinal tract without reducing the number of anaerobic bacteria, the preventive effect is negative in Gram The bacilli are particularly obvious. According to the author's statistics, the decontamination group has almost no pneumonia and respiratory infections (individually resistant to infection) of Klebsiella pneumoniae.
3, to protect the acidic barrier of the stomach is mainly in the prevention of stress ulcers, the use of sucralfin (ulcerlmin) drugs, it can prevent stress ulcer bleeding, but also because it has adsorption of gastric mucosa, change gastric mucus, increase The content of prostaglandin E2 (PGE2) in the gastric cavity and the absorption of pepsin do not change the acidic environment in the stomach, thus effectively preventing ulcers and preventing infection. According to the literature, sucralfate is still intrinsic. Bactericidal activity, a series of studies showed that the incidence of pneumonia in the application of antacid group was 23% to 35%, and the incidence of pneumonia in the application of sucralfate group was 10% to 19%.
4. The biological prevention method for biological prevention of Klebsiella pneumoniae pneumonia is still in the experimental stage. Held et al. used IgM monoclonal antibody (MAb) induced by Klebsiella pneumoniae capsular polysaccharide (CPS) to inject experimental animals to prevent Klebsiella pneumoniae pneumonia, regardless of organ involvement rate, infected tissue The number of bacteria and histological changes in the lungs were much better in the prevention group than in the control group (P<0.01). However, this MAb did not prevent the entry of Klebsiella pneumoniae into the lungs, but accelerated the absorption of infection. Enhance the ability of the lungs to sterilize. There are some similar experimental reports, but mature vaccines and antibodies have not been used in clinical practice and further research is needed. Klebsiella pneumoniae pneumonia has endangered humans for more than a century. With the development of science, the continuous improvement of examination and treatment methods, and the deepening of human understanding, it is believed that it can further reduce its morbidity and mortality, and achieve greater improvement.
Complication
Pneumonia pneumonia complications Complications , septic shock, cerebral palsy
Lung abscess is the most common, followed by empyema and pleural hypertrophy.
Severe cases can be associated with septic shock, and even those with cerebral edema due to cerebral edema.
Symptom
Pneumonia pneumonia symptoms common symptoms chills, high fever, chest pain, fever, cough, slightly...
The onset is sharp, with high fever, cough, sputum and chest pain. There may be purpura, shortness of breath, heart palpitations, about half of the patients have chills, early shock.
Examine
Examination of pneumoniae pneumonia
1, blood routine: blood routine examination is one of the most basic laboratory tests. Blood tests include red blood cells, white blood cells, hemoglobin, and platelet counts. The blood routinely collects the finger blood or the peripheral blood of the earlobe by acupuncture. After dilution, it is dropped into a special calculation disk, and then the number of blood cells is calculated under a microscope. Common symbols on blood routine tests are: RBC stands for red blood cells, WBC stands for white blood cells, Hb stands for hemoglobin (hemoglobin), and PLT stands for platelets.
2, X-ray examination: showing lung or lobular consolidation, multiple cellular lung abscess, leaf gap falling.
3. Bacteriological examination.
Diagnosis
Diagnosis and identification of pneumonia bacilli
Early lack of cough and chest signs, easy to mix with other acute fever, such as vomiting, headache, convulsions or convulsions and other signs, should be different from central nervous system infectious diseases and poisonous bacteria, urgent need for X-ray Affirmative diagnosis, sometimes abdominal pain and vomiting is very obvious, especially in the lower right lobe pneumonia, can stimulate the diaphragm so that abdominal pain in the lower right abdomen, much like acute appendicitis, the attention should be noted that the abdominal tenderness of children with pneumonia is not limited to the right lower abdomen, Abdominal tendon can disappear under mild pressure without deep lagging pain. In addition, when suffering from large leaf pneumonia, the body temperature and total white blood cells are generally higher than those of acute appendicitis. The signs of bronchial tuberculosis with pulmonary lesions or caseous pneumonia X-ray findings, similar to large-leaf pneumonia, but the incidence is slow, the lung shadow disappears slowly, tuberculin test positive, contribute to the diagnosis of tuberculosis, in addition to other pathogen-induced pneumonia such as pneumococcal pneumonia, mycoplasma pneumonia Identification.
