ICU两种常见非发酵菌肺部感染的临床治疗

发布时间：2018-07-01 09:28

  本文选题：非发酵菌 + 肺部感染　； 参考：《新疆医科大学》2014年硕士论文

【摘要】：目的：非发酵菌是需氧不发酵糖类革兰阴性杆菌,广泛分布于水、土壤、医院环境和人体的皮肤表面,属于条件致病菌,并且是住院患者常见的病原体,尤其是免疫缺陷和重症监护病房(intensive care unit, ICU)的危重患者。铜绿假单胞菌(pseudomonas aeruginosa PA)和鲍曼不动杆菌(Acinetobacter baumannii, AB)是常见的非发酵菌,也是临床常见的致病菌。本研究初步探讨痰热清在ICU两种常见非发酵菌肺部感染中的作用,为临床更加有效地治疗非发酵菌提供理论依据。方法：对我院2012年1月-2013年3月重症医学科痰培养提示为鲍曼不动杆菌和铜绿假单胞菌131例患者,其中定植患者10例,肺部感染患者121例,符合两种非发酵菌肺部感染的患者随机分为对照组69例和观察组52例,定植患者随访观察,对照组按照常规治疗法治疗,抗菌素应用根据病原微生物培养及药敏结果确定,观察组在常规治疗的基础上辅助痰热清注射液治疗；通过对比两组患者的一般资料、APACHEⅡ评分的差值、SOFA评分的差值、ICU住院天数、28天内抗菌素使用天数、机械通气的天数及两组28天、90天病死率等指标。结果：通过两组的对比,其两组的一般资料无统计学意义(P0.05)；其中观察组的APACHE Ⅱ评分、SOFA评分的差值明显高于对照组,即观察组APACHE Ⅱ评分、SOFA评分较对照组下降更明显,且观察组ICU住院天数、28天内抗菌素使用天数、机械通气的天数均明显低于对照组(P0.05)；但两组28天、90天病死率无明显差异(P0.05)。结论：痰热清注射液与抗菌素具有协同抗菌作用,对治疗两种常见非发酵菌肺部感染具有一定疗效。
[Abstract]:Objective: Non-fermentative bacteria are aerobic non-fermentative glycosylgram-negative bacilli. They are widely distributed in water, soil, hospital environment and skin surface of human body. They belong to conditional pathogens and are common pathogens in inpatients. Especially critical patients with immune deficiency and intensive care unit (intensive care unit, ICU). Pseudomonas aeruginosa (pseudomonas aeruginosa PA) and Acinetobacter baumannii (Acinetobacter baumannii, AB) are common non-fermentative bacteria and common clinical pathogens. The purpose of this study was to explore the role of Tanreqing in the lung infection of two common non-fermentative bacteria in ICU, and to provide a theoretical basis for the clinical treatment of non-fermentative bacteria. Methods: from January 2012 to March 2013, 131 patients with Acinetobacter baumannii and Pseudomonas aeruginosa were identified as Acinetobacter baumannii and Pseudomonas aeruginosa, including 10 colonized patients and 121 patients with pulmonary infection. Patients with pulmonary infection of two kinds of non-fermentative bacteria were randomly divided into the control group (69 cases) and the observation group (52 cases). The patients in the control group were followed up and observed. The patients in the control group were treated according to the routine therapy, and the application of antibiotics was determined according to the results of pathogenic microorganism culture and drug sensitivity. The observation group was treated with Tanreqing injection on the basis of routine treatment, the difference of Apache 鈪，

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