抗生素降阶梯治疗重症肺炎46例临床观察

Clinical Observation on 46 Cases of Severe Pneumonia Treated by Antibiotic De-escalation Therapy

目的:研究分析抗生素降阶梯治疗对于重症肺炎患者临床治愈率、不良反应及气管插管率的影响。方法:随机选取2015年1月-2016年1月于本院就诊的重症肺炎患者92例,采用随机数字表法分为观察组与对照组,每组46例。对照组患者给予抗生素升级治疗,观察组患者给予抗生素降阶梯治疗,比较两组临床疗效。结果:观察组患者临床治愈率、临床治疗总有效率分别为52.17%、93.48%,均优于对照组的28.26%和78.26%,两组比较差异均有统计学意义(P<0.05);观察组平均抗生素使用时间为(11.32±2.89)d,平均住院时间为(15.67±3.23)d,均短于对照组的(16.78±3.77)d、(20.23±4.19)d,两组比较差异均有统计学意义(P<0.05);观察组气管插管率为15.22%,死亡率为2.17%,不良反应发生率为6.52%,均低于对照组的30.43%、17.39%、19.56%,比较差异均有统计学意义(P<0.05)。结论:采用抗生素降阶梯治疗重症肺炎患者,能够显著提高患者的临床治愈率,降低患者的气管插管率,有效缩短了患者的住院时间以及抗生素使用时间,不良反应发生率低,安全可靠,值得临床推广。

Objective： To study the clinical effect of severe pneumonia treated by antibiotic de-escalation therapy.Method： From January 2015 to January 2016, 92 patients with severe pneumonia treated in our hospital were randomly selected and divided into observation group and control group according to the random number table method, 46 cases in each group.The control group was treated with antibiotics and upgrading treatment, while the observation group was given the antibiotic de-escalation therapy, the clinical curative effect of the two groups were compared.Result： The clinical cure rate and total efficiency of observation group were respectively 52.17% and 93.48%, they were better than those of the control group＇s 28.26%, 78.26%, the differences were statistically significant （ P〈0.05 ） .The average hospitalized time, average antibiotics using time of the observation group were respectively （ 15.67 ± 3.23 ） d and （ 11.32 ± 2.89 ） d, they were shorter than those of the control group＇s （ 20.23 ± 4.19 ） d, （ 16.78 ±3.77 ） d, the differences were statistically significant （ P〈0.05 ） .The tracheal intubation rate, mortality rate, adverse reactions rate of the observation group were respectively 15.22%, 2.17% and 6.52%, which were all lower than those of the control group＇s 30.43%, 17.39% and 19.56%, the differences were statistically significant （ P〈0.05 ） .Conclusion： Antibiotic de-escalation therapy can significantly improve the severe pneumonia patients＇ clinical cure rate, reduce their intubation rate, shorten thier hospitalization time and antibiotic use time, diminish incidence of adverse reactions, which is safe and reliable, worthy of clinical promotion.