比阿培南治疗肝衰竭重度感染患者的效果研究

Clinical efficacy of biapenem in treating liver failure patients with severe infections

目的研究肝衰竭重度感染患者病原菌的分布,探讨其危险因素、临床特点及治疗转归,评价比阿培南治疗肝衰竭重度感染患者的疗效性和安全性。方法选取2012年2月-2015年1月在医院住院的306例肝衰竭重度感染患者,对常见感染指标进行监测,并对采集的标本进行细菌培养,应用比阿培南治疗,观察临床表现变化、疗程及不良反应发生情况,数据采用SPSS 11.5软件进行统计分析。结果 306例肝衰竭重度感染患者中自发性细菌腹膜炎占64.71%,呼吸道感染占26.47%,其他部位感染占8.82%;大肠埃希菌在血液、腹水及尿液培养中分别占40.39%、58.69%、50.00%;而肺炎链球菌在痰液培养最常见为29.41%;应用比阿培南治疗一周总有效率为89.22%、痊愈率为63.73%,治疗两周总有效率为91.50%、痊愈率为86.27%。结论肝衰竭患者感染发生率高,预后差,最常见的重度感染为自发性细菌性腹膜炎;比阿培南治疗肝衰竭合并重度感染患者安全有效且不良反应少。

OBJECTIVE To study the distribution of pathogenic bacteria in patients with liver failure and severe in- fection and to investigate the risk factors, clinical features and treatment end-results as well as to evaluate the effi- cacy and safety of biapenem in treating patients with liver failure and severe infections. METHODS Totally 306 liv- er failure patients complicated with ssevere infections in Jinan Infectious Disease Hospital Affiliated to Shandong University were selected as subjects from Feb. 2012 to Jan. 2015. The clinical manifestations, laboratory results, course of treatment and adverse reactions were observed after using biapenem. All data were statistically analyzed by SPSS 11.5. RESULTS Among 306 liver failure patients complicated with severe infections, spontaneous bacte- rial peritonitis accounted for 64.71% ; respiratory tract infections he＇ld 26.47%, and other parts of the infections accounted for 8.82%. Among these subjects, the proportion of E. coli in blood culture was 40.39%, ascites cul- ture 58.69 % and urine culture 50.00% respectively. And the most common-seen sputum culture was Streptococ- cus pneurnoniae （29.41%）. After the application of biapenem treatment for a week, the total effective rate was 89.22% and curative rate was 63. 73%. After two weeks, the total effective rate and the curative rate were 91.50% and 86.27%. CONCLUSION High incidence of infection and poor prognosis occur often in patients with liver failure and the most common severe infection is spontaneous bacterial peritonitis. Treatment of biapenem in liver failure patients complicated with severe infection is safe and effective with less adverse reactions.