亚胺培南治疗72例卒中相关性肺炎的临床疗效分析

发布时间：2018-04-23 15:36

  本文选题：亚胺培南 + 卒中　； 参考：《重庆医学》2017年26期

【摘要】：目的评价亚胺培南对卒中相关性肺炎(SAP)的临床疗效。方法选择2014年1月至2016年1月在西南医科大学附属医院神经内科重症监护室(NICU)住院的SAP患者72例。在给予患者卒中相关治疗及对症支持治疗的基础上给予亚胺培南1.0g+0.9%生理盐水100mL,每8小时注射1次,观察治疗过程中患者病情变化,比较治疗2周前后实验室检查结果、胸部CT变化,并进行危险因素相关性分析。结果治疗期间死亡病例12例,存活60例。给予亚胺培南治疗后2周体温逐渐降至正常,治疗后美国国立卫生研究院卒中量表(NIHSS)评分、白细胞计数(WBC)、中性粒细胞数、C反应蛋白均较治疗前降低,血气分析显示氧分压氧合指数均较治疗前升高,胸部CT显示炎性渗出病灶及渗出胸水较治疗前吸收好转,72例患者痊愈55例,显效5例,无效12例,总效率83.33%。危险因素相关性分析提示吞咽功能障碍、意识障碍、慢性阻塞性肺疾病急性发作病史均与疗效呈负关联。结论亚胺培南治疗SAP效果满意。
[Abstract]:Objective to evaluate the clinical effect of imipenem on stroke-associated pneumonia (SAP). Methods 72 patients with SAP were selected from January 2014 to January 2016 in the Neurology intensive Care Unit of the affiliated Hospital of Southwest Medical University. On the basis of stroke related treatment and symptomatic support therapy, imipenem 1.0 g 0.9% saline 100mL was injected once every 8 hours. The changes of patients' condition were observed and the results of laboratory examination before and after 2 weeks of treatment were compared. Chest CT changes and risk factors were analyzed. Results there were 12 cases of death and 60 cases of survival during treatment. After treatment with imipenem, the body temperature gradually decreased to normal. After treatment, the National Institutes of Health Stroke scale (NIHSS) score, white blood cell count (WBCU), neutrophil count (neutrophil count) and C-reactive protein (CRP) were all decreased compared with those before treatment. Blood gas analysis showed that oxygen partial pressure oxygenation index was higher than that before treatment. Chest CT showed that inflammatory exudation focus and effusion were better than those before treatment. 55 cases were cured, 5 cases were markedly effective, 12 cases were ineffective, and the total efficiency was 83.33%. Correlation analysis of risk factors showed that dysphagia, disturbance of consciousness, and history of acute attack of chronic obstructive pulmonary disease were all negatively correlated with curative effect. Conclusion imipenem is effective in the treatment of SAP.
【作者单位】： 西南医科大学附属医院神经内科;四川省攀枝花市中心医院神经内科;
【分类号】：R563.1;R743.3
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