临床合理用药杂志
臨床閤理用藥雜誌
림상합리용약잡지
CHINESE JOURNAL OF CLINICAL RATIONAL DRUG USE
2015年
11期
16-17
,共2页
肺部感染,重症%非抗生素治疗%胸腺五肽%丙球蛋白%泛耐药菌珠
肺部感染,重癥%非抗生素治療%胸腺五肽%丙毬蛋白%汎耐藥菌珠
폐부감염,중증%비항생소치료%흉선오태%병구단백%범내약균주
Pulmonary infection,severe%Antibiotic treatment%Thymopentin%γ-globulin%Pan-drug-resistant strains
目的：探讨非抗生素治疗手段在泛耐药菌珠所致老年重症肺部感染疾病治疗中的可行性。方法选取2010年4月－2012年9月机械通气患者81例，根据治疗方案不同将患者分为A组36例及B组45例。 A组治疗措施主要为应用胸腺肽类药物、丙种球蛋白免疫调节剂和血必净，每天进行1～2次的气管镜吸引及灌洗等。 B组在A组的基础上继续给予经验性抗生素治疗。比较2组APACHEⅡ评分、白细胞数、体温及耐药性。结果 A组患者致病菌的耐药性由原来的100．0％广泛耐药特性降至55．2％，而B组患者致病菌耐药性未见明显改变；而白细胞含量经过非抗生素处理干预治疗后的A组白细胞数量有所下降，且与治疗前比较差异有统计学意义（P＜0．05）。治疗1个月，A组死亡2例，病死率为5．6％，而B组死亡10例，病死率为22．2％，差异有统计学意义（P＜0．01）。结论非抗生素治疗可使患者致病菌耐药性下降，降低病死率，具有可行性。
目的：探討非抗生素治療手段在汎耐藥菌珠所緻老年重癥肺部感染疾病治療中的可行性。方法選取2010年4月－2012年9月機械通氣患者81例，根據治療方案不同將患者分為A組36例及B組45例。 A組治療措施主要為應用胸腺肽類藥物、丙種毬蛋白免疫調節劑和血必淨，每天進行1～2次的氣管鏡吸引及灌洗等。 B組在A組的基礎上繼續給予經驗性抗生素治療。比較2組APACHEⅡ評分、白細胞數、體溫及耐藥性。結果 A組患者緻病菌的耐藥性由原來的100．0％廣汎耐藥特性降至55．2％，而B組患者緻病菌耐藥性未見明顯改變；而白細胞含量經過非抗生素處理榦預治療後的A組白細胞數量有所下降，且與治療前比較差異有統計學意義（P＜0．05）。治療1箇月，A組死亡2例，病死率為5．6％，而B組死亡10例，病死率為22．2％，差異有統計學意義（P＜0．01）。結論非抗生素治療可使患者緻病菌耐藥性下降，降低病死率，具有可行性。
목적：탐토비항생소치료수단재범내약균주소치노년중증폐부감염질병치료중적가행성。방법선취2010년4월－2012년9월궤계통기환자81례，근거치료방안불동장환자분위A조36례급B조45례。 A조치료조시주요위응용흉선태류약물、병충구단백면역조절제화혈필정，매천진행1～2차적기관경흡인급관세등。 B조재A조적기출상계속급여경험성항생소치료。비교2조APACHEⅡ평분、백세포수、체온급내약성。결과 A조환자치병균적내약성유원래적100．0％엄범내약특성강지55．2％，이B조환자치병균내약성미견명현개변；이백세포함량경과비항생소처리간예치료후적A조백세포수량유소하강，차여치료전비교차이유통계학의의（P＜0．05）。치료1개월，A조사망2례，병사솔위5．6％，이B조사망10례，병사솔위22．2％，차이유통계학의의（P＜0．01）。결론비항생소치료가사환자치병균내약성하강，강저병사솔，구유가행성。
Objective To investigate the feasibility of non antibiotic therapy on elderly severe pulmonary infection caused by pan-drug-resistant strains .Methods From April 2010 to September 2012 ,81 cases of patients with mechanical ven-tilation were divided into group A (36 cases) and group B (45 cases),according to the different treatments .The group A was mainly given thymic peptide drugs ,gamma globulin immune modulators and Xuebijing for treatment ,and received bronchoscope attraction for 1~2 times a day and irrigation ,etc.On the basis of group A ,the group B continued to be given empirical antibiot-ic treatment.The APACHE Ⅱ score,the number of white blood cell ,temperature and drug resistance of 2 groups were com-pared.Results In group A,the drug resistance of pathogenic bacteria decreased from the original 100% to 55.2%,but pa-tients in the B group had no obvious changes in pathogen resistance .After the non antibiotic treatment intervention treatment , the number of white blood cells decreased in group A ,the difference was statistically significant (P<0.05),compared with be-fore treatment.After 1 months of treatment,2 cases died in group A,the mortality rate was 5.6%,but 10 cases died in group B,the mortality rate was 22.2%,the difference was statistically significant (P<0.01).Conclusion The antibiotic treatment can make patients pathogenic bacteria resistance drop ,reduce the case fatality rate and has the feasibility .
