泵注比阿培南延长给药时间治疗ICU重症感染临床研究

Clinical study on extended-infusion biapenam by bump in treatment of serious infections in ICU

目的:探讨微泵输注比阿培南延长给药时间对重症感染的疗效是否优于传统短时间间断输注法。方法:选择入住ICU,经临床判断需要给予比阿培南治疗的重症感染患者,按最小不平衡指数法随机分组,分为30 min输注组(TI)和3 h输注组(EI),观察2组患者治疗的安全性、有效性及经济性。结果:共纳入128例患者,实际完成104例,延长输注组54例,临床有效率66.7%,传统输注组50例,临床有效率64.0%,2组患者的临床有效率、细菌清除率及不良反应均无统计学显著差异,但是延长输注组比阿培南用药天数[延长输注组:6.6±2.9,传统输注组:(8.1±3.9)d,P=0.035]及人均费用[延长输注组:(3 459±1 752)元,传统输注组:(4 931±2 836)元,P=0.002]显著低于传统输注组。结论:比阿培南延长输注对重症感染的治疗结果优于传统输注,可以作为传统输注法的一种更优替代。

OBJECTIVE To explore whether extended-infusion biapenem was superior to traditional treatment in therapeutic effects against serious infections in ICU. METHODS Patients with serious infections in ICU who needed biapenem were en- rolled. These patients were randomly divided into two groups by the smallest imbalance index method, i. e. , 30 min infusion （TI） group and 3h extended-infusion （EI） group. Clinical efficacy and side effects were observed. RESULTS A total of 128 patients were enrolled and actually 104 finished the study. Fifty four patients in EI group had an effective rate of 66. 7%, and 50 patients in TI group had an effective rate of 64. 0%. No significant difference was observed in clinical efficacy, bacterial clearance and ICU length of stay. But there were significant differences in days of using biapenem （EI： 6. 6 ± 2.9; TI： 8. 1 ± 3.9, P = 0. 035） and drug costs （El： 3 459 ± 1 752; TI： 4 931 ± 2 836, P = 0. 002）. CONCLUSION Outcome of extended-in- fusion biapenem is better than that of traditional infusion, suggesting that El may be the superior substitute for drug adminis- tration.