社区获得性肺炎患者首剂抗生素治疗地点的对照研究

A Control Study of Initial Antibiotic Treatment Site for Patients with Community Acquired Pneumonia

目的通过对两组CAP病人分别在急诊科和住院部行首剂抗生素治疗的对比研究,分析在两个地点行首剂治疗的不同临床效果和经济意义。方法100例社区获得性肺炎患者随机分为两组,分别给予“急诊-首剂-入院”(A组)和“急诊-入院-首剂”(B组)两个模式治疗。比较两组患者的首剂抗生素使用时间、疗效(5天缓解率)、留院时间、治疗费用、死亡率等指标。结果A、B组间比较死亡率没有显著性差异(P>0.05);A组的5天内病情缓解率较高、治疗失败率较少、留院时间和治疗费用均较B组少,有显著性差异(P<0.05)。结论及时在急诊科实施首剂抗生素治疗不仅可以缩短首剂抗生素使用时间、提高疗效、减少治疗失败率,还可以缩短住院时间、节省医疗费用。

Objective This prospective study is to investigate the clinical efficacy and economicvalue of the two different therapeutic strategies for CAP patients. Methods 100 selected CAP cases wererandomized divided into 2 subgroups: One treated with initial dose of antibiotic in the Emergencydepartment (ED), the other without treatment in ED, but treated with initial dose in the inpatient floor.Collected data and compared the differences between the 2 subgroups for clinical results such as doorto needle (initial dose) time, mortality, resolution rate of morbidity (≤5 days), length of hospitalstay and treatment Cost. Results There were no significant difference in mortality between Group A andB(p>0.05); But there were significant differences in door to needle time, resolution rate of morbidity(≤5 days), treatment failure rate, length of hospital stay and treatment cost between the 2 subgroups(p<0.05).Conclusion Early initial dose treated in ED (which resulted in short door to needle time)not only can improve the resolution rate of morbidity (≤5 days), reduce the treatment failure rate, butalso can cut down the length of hospital stay and treatment cost.