临床肺部感染评分干预对老年重症肺炎患者的疗效观察

Clinical pulmonary infection score intervention on elderly patients with severe pneumonia the effect

目的探讨临床肺部感染评分对老年重症肺炎患者抗生素选择策略进行干预后对预后的影响。方法采用随机、对照、开放、临床研究。连续入选符合诊断标准的老年重症肺炎患者78例,随机分为两组:A组(评分干预组,39例)入院时临床肺部感染评分大于6分者抗生素选择策略采用降阶梯治疗方案,小于6分者采用常规升级治疗方案。B组(常规组,39例)按常规自然决定抗生素的选择和疗程。比较两组患者抗生素使用疗程、病死率及真菌定植发生率等。结果A组抗生素使用疗程、病死率显著低于B组,B组真菌定植发生率高于A组。结论临床肺部感染评分干预抗生素选择策略对改善老年重症肺炎的疗效、预后具有良好效果。

Objective Clinical pulmonary infection score in elderly patients with severe pneumonia antibiotic choice strategy to intervene after the prognosis. Methods A randomized, controlled, open, clinical study. Meet the diagnostic criteria for selected elderly patients with 78 cases of severe pneumonia, were randomly divided into two groups： A group （score intervention group, 39 cases） admission of Clinical pulmonary infection score more than six minutes to antibiotics selection strategy adopted de-escalation treatment programmes, Less than six minutes to upgrade the conventional treatment. Group B （ the conventional group, 39 cases） from the regular rounds of antibiotics by doctors decided to natural selection and treatment. Comparing two groups of patients with the use of antibiotics treatment, mortality and the incidence of fungal colonization, and so on. Results Group A result of the use of antibiotic treatment, mortality was significantly lower than in group B, B Group fungal colonization rate higher than the A group. Conclusion Clinical pulmonary infection score intervention strategy to improve the choice of antibiotics older the effect of severe pneumonia, the prognosis is good results.