利奈唑胺治疗意识障碍患者吸入性肺炎的疗效观察

Clinical observation of linezolid for treating aspiration pneumonia patients with conscious disturbance

目的评价利奈唑胺治疗意识障碍吸入性肺炎患者的临床疗效与安全性,以供临床医师选药借鉴。方法选择65例意识障碍吸入性肺炎患者,在应用单一广谱抗菌药物效果欠佳情况下,35例加用替考拉宁、30例加用利奈唑胺,观察两组治疗效果、体温恢复正常时间及其不良反应;采用SPSS13.0软件进行统计分析,计数资料以百分率表示,组间比较采用χ2检验。结果替考拉宁组临床痊愈22例、显效7例、进步1例、无效5例,总有效率为82.9%;6例联合替考拉宁治疗效果不明显者更换为利奈唑胺,5例痊愈、1例显效;利奈唑胺治疗的最终结果为临床痊愈29例、显效5例、进步1例、无效1例,总有效率94.4%;替考拉宁组治疗有效患者5～14d体温恢复正常,中位时间为7.8d;利奈唑胺组治疗有效患者2～10d体温恢复正常,中位时间为3.9d;利奈唑胺组患者出现与利奈唑胺相关的不良反应2例,药物不良反应发生率8.3%。结论利奈唑胺治疗意识障碍患者吸入性肺炎临床疗效确切,且不良反应少,安全性高。

OBJECTIVE To evaluate the clinical efficacy and safety of linezolid in treating aspiration pneumonitis patients with conscious disturbance so as to provide reference for clinical physicians to choose medicine.METHODS A total of 65aspiration pneumonia patients with conscious disturbance were enrolled.After getting poor efficacy with single broad-spectrum antibiotics,35patients were given teicoplanin and 30patients were given linezolid;the therapeutic effects,time for body temperature returning to normal time and adverse reactions of the two groups were observed;SPSS 13.0software was adopted for statistical analysis,enumeration data were expressed by percentage and comparison among groups was tested by Chi-square.RESULTSIn the teicoplanin group,22patients were clinically recovered,7patients presented significant effect,1patient was improved,and 5patients did not present any effect;the total effective rate was 82.9%.Those 6patients who did not present obvious therapeutic effect with teicoplanin changed to use linezolid,5patients were recovered and 1patient presented significant effect.In the linezolid group,29patients were clinically recovered,5patients presented significant effect,1patient was improved and 1patient did not present effect;the total effective rate was 94.4%.Patients in teicoplanin group who had therapeutic effect got body temperature returned to normal within 5to 14days,with the median time of 7.8days;patients in linezolid group who had therapeutic effect got body temperature returned to normal within 2to 10days, with the median time of 3.9days.However,the adverse reaction related to linezolid occurred in 2patients in the linezolid group,and the adverse drug reaction rate was 8.3%.CONCLUSION Linezolid has significant clinical effect in the treatment of aspiration pneumonitis patients with conscious disturbance,with less adverse reaction and higher safety.