美罗培南不同给药方式治疗重症肺炎的临床疗效比较研究

A comparative study on the efficacy of different administrations of meropenem in the treatment of severe pneumonia

目的探讨美罗培南不同给药方式治疗重症肺炎的临床疗效。方法选取2013年9月—2016年2月于乐山市老年病专科医院收治的重症肺炎患者96例,随机分为A、B、C组,每组32例。3组患者均予以美罗培南治疗,A组持续泵入给药,B组延长输注给药,C组采取传统静脉滴注给药,比较3组患者临床疗效、临床指标[体温(T)、白细胞计数(WBC)、动脉血氧分压(Pa O_2)、临床肺部感染量表(CPIS)评分、氧合指数]、临床分离菌株药敏测定结果、其他临床指标(ICU入住时间、肺部炎性渗出病灶吸收时间、机械通气时间、抗生素费用支出)。结果 A患者临床疗效优于B组、C组(P<0.05)。A组患者T、CPIS评分低于B组、C组,WBC少于B组、C组,Pa O_2、氧合指数高于B组、C组(P<0.05)。A组患者分离菌株敏感率高于B组、C组(P<0.05)。A组患者ICU入住时间、肺部炎性渗出病灶吸收时间、机械通气时间短于B组、C组,抗生素费用支出少于B组、C组(P<0.05)。结论美罗培南持续泵入给药治疗重症肺炎的临床疗效优于传统静脉滴注与延长输注给药。

Objective To investigate the clinical efl＇ect of different administrations of meropenem in the treatment of severe pneumonia. Methods A total of 96 eases of patients with severe pneumonia were selected from September 2013 to February 2016 in Leshan Specialized Seniors Hospital, which were randomly divided into A, B, C group, 32 cases in each group. All groups were treated with meropenem, A group was continuous pumping, B group was prolonging the infusion, C group was given traditional intravenous infusion. The clinical effect, clinical indicator （T, WBC, PaO2, CPIS score, PaO2/FiO2）, results of drug susceptibility test in clinical isolates and length of ICU stay, absorption time of inflammatory exudation in lung, mechanical ventilation time and antibiotic expense were compared among the three groups. Results The clinical effect of A group was better than B, C group （P〈0.05）. A group ofT, CPIS score were lower than B, C group, WBC was less than B, C group, PaO2, PaO2/FiO2 were higher than B, C group （P 〈 0. 05 ）. Sensitivity of isolated strain of A group was higher than B, C group （P 〈0. 05）. The A group of length of ICU stay, absorption time of inflammatory exudation in hmg, mechanical ventilation time were shorter than B, C group, antibiotic expense was less than B, C group （ P 〈 0. 05）. Conclusion Continuous pumping meropenem is more effective than traditional intravenous infusion and prolonged infusion in treating severe pneumonia.