CAJ | 학술논문

目的设计一种药物轮换、分期、长疗程的治疗方法,以临床治愈为目标,观察该方法对老年复发性尿路感染患者的疗效.方法将入选患者分为老年组(年龄≥65岁)30例和非老年组48例,选择数种有效抗生素轮换应用.采用分期治疗方法:(1)治疗期:抗生素按常规剂量应用,直至尿常规正常;(2)巩固期:抗生素减量应用;(3)维持期:抗生素减为每晚1次,维持治疗3个月;(4)观察期:停用抗生素,观察半年.上述各分期如尿常规检查有反复,则转为前一期治疗.结果 78例患者中,治愈69例(88.5%),有效7例(8.9%),无效2例(2.6%).老年组分别为28例、1例、1例;非老年组分别为41例、6例、1例,两组治愈率差异无统计学意义(F=0.469,).老年组与非老年组比较,治愈总疗程[(54.8±16.2)周对(44.5±13.7)周,t=2.8467,P＜0.01]、治疗期[(34.3±15.2)周对(26.2±14.8)局,t=2.2081,P＜0.05]、巩固期[(5.7±2.6)周对(4.1±0.2)周,t=3.9369,P＜0.01]均延长;但两组维持期[(14.8±4.6)周对(14.2±3.1)周]比较,差异无统计学意义(t=0.6480,P＞0.05).治疗前后两组血常规、肝肾功能均无明显变化.结论对老年复发性尿路感染患者采用药物轮换、分期、长疗程治疗,治愈率高;但老年组所需治疗时间比非老年组长.未见影响血常规、肝肾功能等不良反应.
목적 설계일충약물륜환、분기、장료정적치료방법,이림상치유위목표,관찰해방법대노년복발성뇨로감염환자적료효.방법 장입선환자분위노년조(년령≥65세)30례화비노년조48례,선택수충유효항생소륜환응용.채용분기치료방법:(1)치료기:항생소안상규제량응용,직지뇨상규정상;(2)공고기:항생소감량응용;(3)유지기:항생소감위매만1차,유지치료3개월;(4)관찰기:정용항생소,관찰반년.상술각분기여뇨상규검사유반복,칙전위전일기치료.결과 78례환자중,치유69례(88.5%),유효7례(8.9%),무효2례(2.6%).노년조분별위28례、1례、1례;비노년조분별위41례、6례、1례,량조치유솔차이무통계학의의(F=0.469,).노년조여비노년조비교,치유총료정[(54.8±16.2)주대(44.5±13.7)주,t=2.8467,P＜0.01]、치료기[(34.3±15.2)주대(26.2±14.8)국,t=2.2081,P＜0.05]、공고기[(5.7±2.6)주대(4.1±0.2)주,t=3.9369,P＜0.01]균연장;단량조유지기[(14.8±4.6)주대(14.2±3.1)주]비교,차이무통계학의의(t=0.6480,P＞0.05).치료전후량조혈상규、간신공능균무명현변화.결론 대노년복발성뇨로감염환자채용약물륜환、분기、장료정치료,치유솔고;단노년조소수치료시간비비노년조장.미견영향혈상규、간신공능등불량반응.
Objective To observe the therapeutic effects of the drugs alternation multiple stages and long term therapy in elderly patients with recurrent urinary tract infection.Methods The patients were divided into elderly group (age≥65 years,n=30) and non-elderly group (n=48).The multiple effective antibiotics were selected for alternate use.The treatment included four periods as follows:(1)Treatment period:the regular dose of antibiotic was maintained until the urine routine test result became normal;(2)Consolidation period:the dosage of antibiotic was reduced;(3)Maintenance period:the dosage of antibiotic was reduced to once every night and the treatment should be kept for three months;(4)Observation period:the patients were observed for six months after withdrawal of antibiotics.During the treatment,if the urine routine test became abnormal repeatedly,the patient should return to the previous treatment period.During the treatment and consolidation period,each medication should be applied for one week alternatively.Results Among 78 patients,69 cases (88.5%) were cured,7 cases (8.9%) were effective,and two cases (2.56%) were invalid.There were 28 cured cases,1 effective case and 1 invalid case in elderly group.The corresponding data were 41,6 and 1 in non-elderly group,respectively.There was no difference in cure rate between the two groups (F= 0.469).Compared with non-elderly group,the overall treatment time [(54.8± 16.2)weeks vs.(44.5± 13.7) weeks,t= 2.8467,P＜0.01],treatment period [( 34.3± 15.2) weeks vs.(26.2±14.8) weeks,t=2.2081,P＜0.05] and consolidation period [(5.7±2.6) weeks vs.(4.1±0.2) weeks,t=3.9369,P＜0.01] were all prolonged in elderly group.But there was no difference in maintenance period [(14.8±4.6) weeks vs.(14.2±3.1) weeks,t=0.6480,P＞0.05].There were no markedly changes in blood routine,liver and kidney function during the course of treatment.Conclusions For the elderly patients with recurrent urinary tract infection,the drugs alternation,multiple stages and long-term treatment has a high cure rate and no adverse effect on blood routine,liver and renal function.