CAJ | 학술논문

目的：探讨头孢曲松钠联合氟康唑治疗老年重症社区获得性肺炎的疗效。方法选择2010年3月至2013年3月房县人民医院收治的老年重症社区获得性肺炎患者150例，根据随机抽签法分为对照组与观察组，各75例。对照组使用头孢曲松钠1.0 g加入0.9％氯化钠注射液100 mL 静脉滴注，每日1次；观察组在对照组治疗的基础上每2日口服一次氟康唑片，剂量为6 mg／kg，两组患者的疗程均为4周。比较两组患者的预后疗效及不良反应发生情况。结果观察组细菌学清除总有效率显著高于对照组（97.3％比89.3％），综合总有效率显著高于对照组（94.7％比86.7％），观察组细菌清除和综合疗效均优于对照组（uc ＝6.692，7.063，均P＜0.05）。观察组住院时间、体温恢复正常时间与咳嗽消失时间分别为（7.15±0.26） d、（5.62±0.22） d、（6.25±0.36） d，均显著短于对照组的（9.65±0.45） d、（7.26±0.29） d、（8.00±0.41） d，差异有统计学意义（P＜0.01）。两组不良反应发生率比较差异无统计学意义（ P ＞0.05）。结论头孢曲松钠联合氟康唑治疗老年重症社区获得性肺炎能取得更好的效果，安全性好，从而促进患者的康复。
목적：탐토두포곡송납연합불강서치료노년중증사구획득성폐염적료효。방법선택2010년3월지2013년3월방현인민의원수치적노년중증사구획득성폐염환자150례，근거수궤추첨법분위대조조여관찰조，각75례。대조조사용두포곡송납1.0 g가입0.9％록화납주사액100 mL 정맥적주，매일1차；관찰조재대조조치료적기출상매2일구복일차불강서편，제량위6 mg／kg，량조환자적료정균위4주。비교량조환자적예후료효급불량반응발생정황。결과관찰조세균학청제총유효솔현저고우대조조（97.3％비89.3％），종합총유효솔현저고우대조조（94.7％비86.7％），관찰조세균청제화종합료효균우우대조조（uc ＝6.692，7.063，균P＜0.05）。관찰조주원시간、체온회복정상시간여해수소실시간분별위（7.15±0.26） d、（5.62±0.22） d、（6.25±0.36） d，균현저단우대조조적（9.65±0.45） d、（7.26±0.29） d、（8.00±0.41） d，차이유통계학의의（P＜0.01）。량조불량반응발생솔비교차이무통계학의의（ P ＞0.05）。결론두포곡송납연합불강서치료노년중증사구획득성폐염능취득경호적효과，안전성호，종이촉진환자적강복。
Objective To investigate the clinical efficacy of Ceftriaxone Sodium combined fluconazole for treating severe community-acquired pneumonia in elderly patients.Methods Total of 150 elderly patients with severe community-acquired pneumonia admitted to Fangxian People′s Hospital from Mar.2010 to Mar.2013 were randomly divided into observation group and control group,75 cases in each group.The control group was treated with 1.0 g of ceftriaxone sodium and saline 100 mL,intravenous infusion,once daily.The observation group was added once every two days of oral fluconazole tablets( dose 6 mg/kg) on the basis of the control group′s therapy ,both groups were treated for 4 weeks.The efficacy and adverse reactions of the two groups were observed.Results The total effective bacteriological clearance and consolidated total effective rate were 97.3% and 94.7% in the observation group, of the control group were 89.3% and 86.7%,the difference between the two groups were statistically significant(uc =6.692,7.063,both P <0.05).The observation group′s hospitalization,body temperature returning to normal and the cough disappea-ring time were (7.15 ±0.26) d,(5.62 ±0.22) d, (6.25 ±0.36) d, significantly less than the control group′s (9.65 ±0.45) d, (7.26 ±0.29) d,(8.00 ±0.41) d,the differences were statistically significant (P<0.01).There were no significant in the incidence of adverse reaction between two groups(P>0.05). Conclusion Ceftriaxone sodium combined fluconazole treatment of elderly patients with severe community-acquired pneumonia can achieve better results with better safett, and promote the recovery of the patients.