利奈唑胺治疗 ICU 革兰阳性球菌感染效果观察

Clinical efficacy and safety of linezolid in the treatment of ICU Gram -positive bacterial infections

目的：探讨对 ICU 革兰阳性球菌感染患者应用利奈唑胺治疗的临床疗效及安全性。方法选择2015年7月至2016年7月收治的 ICU 革兰阳性球菌感染患者100例，按照随机数字表法分为观察组与对照组，每组50例。观察组给予利奈唑胺静脉滴注，0．6 g／次，每次间隔12小时，连续用药1周；对照组给予万古霉素静脉滴注，1 g／次，每次间隔12小时，连续用药1周。观察两组患者的致病菌及感染部位，分析两组临床疗效及不良反应发生率。结果肠球菌和金黄葡萄球菌感染为感染率较高的两种致病菌，观察组肠球菌感染的概率为32．00％金黄葡萄球菌感染率为62．00％，对照组肠球菌感染的概率为32．00％，金黄葡萄球菌感染的概率为60．00％；肺部感染与腹腔感染为患者最易感染的部位，观察组肺部感染率为46．00％，腹部感染率为28．00％，对照组肺部感染率为50．00％，腹部感染率为32．00％。观察组总临床治疗有效率为86．00％，对照组的总临床治疗有效率为52．00％，相比对照组，观察组临床有效率显著提高（χ2＝16．00，P ＝0．001）。观察组不良反应率为4．00％，对照组不良反应率为22．00％；观察组不良反应发生率显著低于对照组（χ2＝7.384，P ＝0．007）。结论利奈唑胺对 ICU 革兰阳性球菌感染患者具有良好的疗效，值得在临床治疗中进行推广。

Objective To observe the clinical efficacy and safety of linezolid in the treatment of ICU patients with Gram -positive bacterial infections.Methods 100 cases of Gram -positive bacterial infections from June 2015 to July 2016 were selected and randomly divided into two groups,including observation group （50 patients）and control＆nbsp;group （50 patients）according to random number table.The observation group was treated with linezolid intravenous drip,0.6g/time,each time interval of 12 hours,treated for 1 week.The control group was given intravenous vancomy-cin,1g/time,each time interval of 12 hours medication for a week.The infected sites,pathogens clinical efficacy and the incidence of adverse reactions were analyzed.Results Two kinds of pathogenic bacteria with high infection rate were caused by Staphylococcus aureus infection,and the probability of infection in observation group was 32%,the infection rate was 62%,that in the control group was 24%,and the probability of Staphylococcus aureus infection was 60%.Lung infection and abdominal infection were the most easily infected organs.The lung infection rate of observa-tion group was 46%,abdominal infection rate was 28%,in control group,lung infection rate was 38%,abdominal infection rate was 30%.After treatment,the total effective rate of the observation group was 86%,which was signifi-cantly higher than 52% of the control group （χ2 =16.00,P =0.001 ）.The incidence rate of adverse reactions of observation group was 4%,which was significantly lower than 22% of the control group （χ2 =7.384,P =0.007）. Conclusion Linezolid in the treatment of ICU Gram -positive bacterial infections has good effect,and it is worth to be recommended.