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中华重症医学电子杂志 ›› 2022, Vol. 08 ›› Issue (03) : 276 -280. doi: 10.3877/cma.j.issn.2096-1537.2022.03.017

病例报告

社区获得性鲍曼不动杆菌肺炎一例并文献回顾
刘永海1, 祁航1, 周婷1, 张巍1,()   
  1. 1. 214000 江苏无锡,江苏省无锡市惠山区人民医院重症医学科
  • 收稿日期:2022-03-22 出版日期:2022-08-28
  • 通信作者: 张巍

A case of community-acquired Acinetobacter baumannii pneumonia and a literature review

Yonghai Liu1, Hang Qi1, Ting Zhou1, Wei Zhang1,()   

  1. 1. Department of Critical Care Medicine, Huishan District People's Hospital, Wuxi 214000, China
  • Received:2022-03-22 Published:2022-08-28
  • Corresponding author: Wei Zhang
引用本文:

刘永海, 祁航, 周婷, 张巍. 社区获得性鲍曼不动杆菌肺炎一例并文献回顾[J/OL]. 中华重症医学电子杂志, 2022, 08(03): 276-280.

Yonghai Liu, Hang Qi, Ting Zhou, Wei Zhang. A case of community-acquired Acinetobacter baumannii pneumonia and a literature review[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2022, 08(03): 276-280.

本文报道1例社区获得性鲍曼不动杆菌肺炎患者,并发急性呼吸窘迫综合征(ARDS),先后采取小潮气量肺保护性通气、滴定式液体复苏、俯卧位通气、连续性肾替代治疗(CRRT)稳定内环境、调整抗生素剂量、升级抗生素、体外膜肺氧合(ECMO)等治疗,但病情还是进展加重,最终死亡。回顾治疗过程,感染未能完全控制是患者死亡的主要原因。因此,本文将患者的病情发展、治疗过程加以总结,以期为类似患者改善预后提供经验。

A patient with community-acquired Acinetobacter baumannii pneumonia complicated with acute respiratory distress syndrome (ARDS) was treated in our department. With low tidal volume lung protective ventilation, titrated fluid resuscitation, prone position ventilation, continuous renal replacement therapy (CRRT) intense antibiotic therapy and extracorporeal membrane oxygenation (ECMO) the disease still progressed and eventually the patient died. The failure to fully control the infection might be the main cause of death. This paper summarizes the development and treatment of the disease in order to provide experience for similar patients and improve their prognosis.

图1 社区获得性鲍曼不动杆菌肺炎患者入院当日(2020年12月23日)肺部CT。示肺窗及纵隔窗可见双肺炎症性改变,左侧为重,伴左肺下叶实变影,可见支气管充气征。图a为肺窗;图b为纵膈窗
图2 社区获得性鲍曼不动杆菌肺炎患者感染指标变化趋势注:CRP为C反应蛋白;PCT为降钙素原;WBC为白细胞计数
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