CAJ | 학술논문

目的观察头孢吡肟联合阿米卡星治疗克雷伯杆菌引发肺炎的效果。方法选择2013年1-12月来我院就诊的克雷伯杆菌肺炎患者86例，依据治疗方法的不同将患者分为治疗组和对照组，每组43例。对照组应用头孢哌酮联合庆大霉素治疗，治疗组应用头孢吡肟联合阿米卡星进行治疗。分别于治疗前及获知痰培养药敏结果后，检测患者白细胞计数（ WBC）、C反应蛋白（ CRP）、动脉血氧分压（ PaO2）、尿蛋白、呼吸频率、红细胞沉降速率（ ESR）、体温，比较两组呼吸困难、紫绀、寒战及死亡例数。结果治疗前，两组患者的WBC、CRP、PaO2、尿蛋白、呼吸频率、ESR、体温、呼吸困难例数、紫绀例数及寒战例数比较差异无统计学意义（ P＞0.05）。治疗组患者获知痰培养药敏结果后的WBC、CRP、尿蛋白、呼吸频率、ESR、体温、呼吸困难例数、紫绀例数、寒战例数均明显低于对照组（P＜0.05）；治疗组、对照组患者的PaO2分别为（82.16±19.21）、（73.24±18.17） mmHg，治疗组明显高于对照组（ P＜0.05）。结论应用头孢吡肟联合阿米卡星可明显提高克雷伯杆菌肺炎患者的治疗效果，减轻患者的临床症状并降低死亡率。
목적관찰두포필우연합아미잡성치료극뢰백간균인발폐염적효과。방법선택2013년1-12월래아원취진적극뢰백간균폐염환자86례，의거치료방법적불동장환자분위치료조화대조조，매조43례。대조조응용두포고동연합경대매소치료，치료조응용두포필우연합아미잡성진행치료。분별우치료전급획지담배양약민결과후，검측환자백세포계수（ WBC）、C반응단백（ CRP）、동맥혈양분압（ PaO2）、뇨단백、호흡빈솔、홍세포침강속솔（ ESR）、체온，비교량조호흡곤난、자감、한전급사망례수。결과치료전，량조환자적WBC、CRP、PaO2、뇨단백、호흡빈솔、ESR、체온、호흡곤난례수、자감례수급한전례수비교차이무통계학의의（ P＞0.05）。치료조환자획지담배양약민결과후적WBC、CRP、뇨단백、호흡빈솔、ESR、체온、호흡곤난례수、자감례수、한전례수균명현저우대조조（P＜0.05）；치료조、대조조환자적PaO2분별위（82.16±19.21）、（73.24±18.17） mmHg，치료조명현고우대조조（ P＜0.05）。결론응용두포필우연합아미잡성가명현제고극뢰백간균폐염환자적치료효과，감경환자적림상증상병강저사망솔。
Objective To explore the effect of cefepime combined with amikacin on klebsiella pneumonia. Methods 86 patients with klebsiella pneumonia of our hospital from January to December 2013 were selected.The pa-tients were divided into treatment group (n=43) and control group (n=43) according to the different treatment meth-ods.Patients in control group were given cefepime and gentamicin,and patients in treatment group were given cefepime and amikacin.The indexes,such as white blood cell count ( WBC) ,C-reactive protein ( CRP) ,arterial oxygen pressure (PaO2),protein in urine,respiratory rate,blood cell sedimentation rate (ESR),temperature were detected,and the number of patients with dyspnea,cyanosis,shiver,deaths was recorded respectively before treatment and after the results of sensitivity detection of sputum culture.Results There was no significant difference in the above indexes between the two groups before treatment (P>0.05).The WBC,CRP,urine protein,respiratory rate,ESR,body temperature, and the number of patients with dyspnea,cyanosis,shiver in treatment group were significantly lower than those of con-trol group after the result of susceptibility test ( P<0.05 ) .The PaO2 in treatment group was higher than that of control group:(82.16 ±19.21) mmHg vs.(73.24 ±18.17) mmHg,P<0.05.Conclusion Cefepime combined with amika-cin can significantly improve the efficacy and clinical symptoms of klebsiella pneumonia and reduce the mortality.