亚胺培南/西司他丁对重症肺炎的降阶梯治疗疗效分析

Stage Rescue Effects of Imipenem with Cilastatin Against Serious Pneumonia

目的观察亚胺培南/西司他丁(TPM)对重症肺炎降阶梯治疗的疗效。方法将急诊入住ICU的32例重症肺炎分为两组:一组入院前静脉未给予抗菌药物(未治疗组,15例);另一组入院前曾静脉应用抗菌药物但无效者(已治疗组,17例),入院后均接受静脉用亚胺培南/西司他丁治疗,观察疗效及转归。结果两组在年龄、治疗前合并心、肾等脏器功能不全和呼吸机依赖等病理特征差异无明显性(P>0.05),但未治疗组发病时间较短、呼吸衰竭程度更严重(P<0.05);接受亚胺培南/西司他丁治疗后,未治疗组所需机械通气时间和住ICU时间比已治疗组明显缩短(P<0.05);未治疗组的总有效率为80%,已治疗组为47%(P<0.05)。结论经验性治疗将亚胺培南/西司他丁作为重症肺炎起始用药,可防止病情迅速恶化,随后根据病原学及临床效果换用针对性抗菌药物的降阶梯疗法有其合理性。

OBJECTIVE To observe the stage rescue effects of imipenem with cilastatin against serious pneumonia. METHODS The 32 serious pneumonia ICU patients were divided into 2 groups: all the people who did not administrate antibiotics were in group 1, the others were in group 2. All the patients were administrated imipenem with cilastatin. RESULTS There were no (significant) difference of pathology feature between 2 groups. There were (significant) difference in the duration time and the degree of respiration failure between 2 groups. The effective rate of group 1 was 80% and group 2 was 47%. CONCLUSIONS Imipenem with cilastatin could be of first choice to prevent disease worse and change the antibiotic by clinical effect.