序贯疗法治疗老年肺部感染的临床疗效评价

发布时间：2018-06-08 16:32

本文选题：肺部感染 + β-内酰胺类　；参考：《中华医院感染学杂志》2017年04期

【摘要】：目的探讨抗菌药物序贯疗法治疗老年肺部感染的疗效及临床应用价值。方法选取2015年8月-2016年11月医院呼吸内科60例老年肺部感染患者为研究对象,随机分为序贯治疗组30例,持续静脉滴注组30例,两组分别采用不同的治疗方法,持续静脉注射组给予β-内酰胺类(包括第二、三代头孢菌素类、半合成青霉素、β-内酰胺类加酶抑制剂)、大环内脂类抗菌药物(包括红霉素、罗红霉素、阿奇霉素)、氟喹诺酮类(包括氧氟沙星、环丙沙星)滴注;序贯治疗组采用相同种类抗菌药物治疗,先静脉给药、待病情稳定后改为口服抗菌药物序贯治疗。结果序贯治疗组患者体温恢复正常、咳嗽咳痰减轻、肺部Up音减少的时间,分别为(3.62±0.65)d、(3.53±0.51)d、(3.87±0.73)d,显著低于持续静脉滴注组(4.28±0.69)d、(4.63±0.82)d、(4.73±0.87)d,差异有统计学意义(P0.05);序贯治疗组患者细菌清除率和总有效率显著高于持续静脉滴注组患者,差异有统计学意义(P0.05);序贯治疗组患者的药物不良反应率显著低于持续静脉滴注组患者,差异有统计学意义(P0.05)。结论使用抗菌药物序贯疗法治疗老年肺部感染不仅可以取得较好的临床疗效,还可以有效降低药物不良反应,更安全可靠。
[Abstract]:Objective to evaluate the efficacy and clinical value of sequential antimicrobial therapy in the treatment of senile pulmonary infection. Methods from August 2015 to November 2016, 60 elderly patients with pulmonary infection were randomly divided into sequential treatment group (n = 30) and continuous intravenous drip group (n = 30). Continuous intravenous administration of 尾 -lactams (including the second and third generation cephalosporins, semi-synthetic penicillin, 尾 -lactam inhibitor), macrocyclic lipids (including erythromycin, roxithromycin), Azithromycin, fluoroquinolones (including ofloxacin, ciprofloxacin); sequential treatment group with the same kind of antimicrobial treatment, first intravenous administration, after stable state of illness to oral antimicrobial sequential treatment. Results in the sequential treatment group, the temperature returned to normal, the cough and expectoration relieved, and the lung Up-tone decreased. The bacterial clearance rate and the total effective rate in sequential treatment group were significantly higher than those in continuous intravenous drip group (4.28 卤0.69) and 4.63 卤0.82 卤0.87 days, respectively, and the bacterial clearance rate and total effective rate in sequential treatment group were significantly higher than those in continuous intravenous drip group, the difference was statistically significant (P 0.05), and the bacterial clearance rate and total effective rate in sequential treatment group were significantly higher than those in the continuous intravenous drip group (P < 0.05), and were significantly lower than those in the continuous intravenous drip group (P < 0.05), and were significantly lower than those in the continuous intravenous drip group (P < 0.05). The adverse drug reaction rate in sequential treatment group was significantly lower than that in continuous intravenous drip group (P 0.05). Conclusion Sequential antimicrobial therapy is not only effective in the treatment of pulmonary infection in the elderly, but also can effectively reduce adverse drug reactions and be more safe and reliable.
【作者单位】：郑州大学附属郑州市中心医院老年医学部普通内科;
【基金】：河南省重点科技攻关基金资助项目(152102310184)
【分类号】：R563.1

【参考文献】