比阿培南联合左氧氟沙星治疗老年重症肺炎的临床效果观察

Effect Observation of Biapenem Combined with Levofloxacin in Treatment of Elderly Patients with Severe Pneumonia

目的探讨比阿培南联合左氧氟沙星治疗老年重症肺炎的临床效果。方法选择我科收治的老年重症肺炎164例,按照随机数字表法分为对照组与治疗组,每组各82例。两组均予静脉滴注比阿培南、吸氧、祛痰等常规处理;治疗组在此基础上静脉滴注左氧氟沙星。两组均治疗10 d,观察临床症状、体征及医技检查恢复正常时间,记录实验室相关指标变化、临床效果、细菌清除率及不良反应发生率。结果与本组治疗前比较,治疗后两组白细胞(WBC)、C反应蛋白(CRP)、降钙素原(PCT)水平均降低,氧合指数升高,差异均有统计学意义(P<0.05);与对照组比较,治疗组治疗后WBC、CRP、PCT水平明显降低,氧合指数明显升高,差异均有统计学意义(P<0.05)。与对照组比较,治疗组体温恢复正常、咳嗽咳痰消失、肺部啰音消失、WBC恢复正常及X线胸片阴影消失时间均明显缩短,差异有统计学意义(P<0.05)。两组治疗总有效率及细菌清除率比较差异具有统计学意义(P<0.05),但两组不良反应发生率比较差异无统计学意义(P>0.05)。结论比阿培南联合左氧氟沙星治疗老年重症肺炎起效快、效果好,且安全性较高。

Objective To investigate clinical effect of Biapenem combined with Levofloxacin in treatment of elderly patients with severe pneumonia. Methods A total of 164 elderly patients with severe pneumonia were divided into control group （n=82） and therapy group （n=82） according to random digits table method. All patients received routine treatments such as iv gtt Biapenem, oxygen inhalation and expelling phlegm, and therapy group was added with iv gtt Levofloxacin, and the two groups were all treated for 10 d. Clinical symptoms, signs and recovering to normal time of medical examinations were observed, and changes of related laboratory indexes, clinical effect, bacterial clearance rate and incidence rate of adverse re-action were recorded in two groups. Results Compared with those before treatment in the same group, after treatment, white blood cell （ WBC） , C-reactive protein （ CRP） and procalcitonin （ PCT） levels were significantly decreased, while valuess of oxygenation indexes were significantly increased in two groups （P〈0. 05）. Compared with those in control group, after treat-ment, WBC, CRP and PCT levels were significantly decreased, while values of oxygenation indexes were significantly in-creased in therapy group （P〈0. 05）;returning to normal body temperature time, disappearance times of cough, expectoration and rale in lung, returning to normal WBC level and shadow disappearance time by chest x-ray film were significantly shorter in therapy group （P〈0. 05）. There were significant differences in the total effective rate and bacterial clearance rate （P〈0. 05）, but there was no significant difference in incidence rate of adverse reaction between two groups （P〈0. 05）. Conclu-sion Biapenem combined with Levofloxacin in treatment of elderly patients with severe pneumonia may achieve quick and good effectiveness with safety.