SAŽETAK

I pored primene savremenih dijagnostičkih postupaka, novih metoda mikrobiološke detekcije, brojnih efikasnih antimikrobnih lekova, pneumonije i dalje predstavljaju značajan medicinski i socijalni problem savremenog sveta. U radu su prikazane kliničke i radiološke karakteristike kao i dijagnostičke mogućnosti kod 1536 pacijenata koji su u periodu od 1. januara 1995. g. do 31. maja 2000. g. otpušteni iz Instituta za plućne bolesti u Sremskoj Kamenici, sa dijagnozom upale pluća. U ispitivanoj grupi pacijenata muškarci čine 62,4%. Pridružene bolesti su prisutne kod 66,73% pacijenata, pri čemu su hronične opstruktivne plućne bolesti zastupljene u 43,75%. Najčešće prisutan simptom je kašalj (93,94%) a zatim povišena telesna temperatura (86,91%). Obostranu pneumoniju imalo je 16,7% pacijenata a jednostranu 83,3%. U slučaju jednostrane pneumonije najčešća lokalizacija je u desnom donjem režnju (31,5%) a zatim u levom donjem režnju (28%). Bronhoskopija je rađena kod 52,5% pacijenata a endoskopski nalaz je najčešće bio uredan, kod 84,6% pacijenata. Mikrobiološkom analizom sputuma, etiološki uzročnik pneumonije dokazan je kod 16,5% pacijenata, a najčešće izolovan uzročnik je Streptococcus pneumoniae (36,6%). Letalni ishod nastupio je kod 7,81% pacijenata, pri čemu je među pacijentima hospitalizovanim na Intenzivnoj terapiji umrlo 36%, a među hospitalizovanim na ostalim kliničkim odeljenjima umrlo je 4,3%.

Ključne reči: pneumonija, etiologija, klinička slika, radiološki nalaz

SUMMARY

Despite the application of the most-up-to date diagnostic procedures and methods of microbiological detection, as well as a variety of efficient antimicrobial drugs, pneumonia still represents a major medical and social issue throughout the world. The study reviews clinical and radiological characteristics as well as diagnostic modalities in 1536 patients with pneumonia discharged from the Institute for Pulmonary Diseases in Sremska Kamenica over the period June 1, 1995 - May 31, 2000. The males made 62.4% of the examined group. Concomitant diseases were registered in 66.73 % of the patients, with bronchoobstructive pulmonary diseases found in 43.75%. Cough and fever were the most common symptoms, registered in 93.94% and 86.91% of the patients respectively. Bilateral pneumonia was found in 16.7% of the patients, while 83.3% of them had a unilateral disease. Unilateral pnumonia was most commonly localized in the right lower (31.5%) and left lower lobe (28%). Bronchoscopy was performed in 52,5% of the patients, providing a normal finding in the majority of the examined patients (84.6%). Microbiological sputum analysis established the etiological agent of the disease in 16.5% of the patients, with Streptococcus pneumoniae for the most common one (36.6%). Pneumonia had a fatal outcome in 7.81%; of the deceased,36% were hospitalized at the Intensive Care Unit and 4.3% at other clinical departments of the Institute.

Key words: pneumonia, etiology, clinical presentation, radiological finding

Doc. dr sc med. Mirna Đurić
Klinika za opštu pulmologiju, Institut za plućne bolesti, Sremska Kamenica