抗生素降阶梯疗法对重症肺炎患者的临床疗效评价

Evaluation on the Clinical Efficacy of Antibiotic Deescalation Therapy in Patients With Severe Pneumonia

目的探讨抗生素降阶梯疗法对重症肺炎患者的临床疗效。方法收集我院重症肺炎患者,分为:研究组(30例,接受抗生素降阶梯疗法)和对照组(30例,接受常规抗生素治疗)。对比两组治疗前后72小时白细胞值及CRP;两组临床症状改善时间;两组重症肺炎有效率;两组用药期间药物不良反应分析。结果研究组和对照组治疗前白细胞值及CRP分别为[(18.68±2.47)×109/L、(28.82±3.35)mg/L]、[(18.54±2.69)×109/L、(29.01±3.16)mg/L)],比较差异无统计学意义(P> 0.05);研究组和对照组治疗后72小时白细胞值及CRP分别为[(10.28±2.69)×109/L、(6.34±2.12)mg/L]、[(15.26±3.47)×109/L、(10.34±2.58)mg/L],比较差异有统计学意义(P <0.05);两组临床症状改善时间(体温恢复正常时间、呼吸平稳时间、啰音消失时间、病情稳定时间)比较差异有统计学意义(P<0.05);研究组和对照组重症肺炎有效率分别为100.00%、83.33%,比较差异有统计学意义(P <0.05)。结论相对于常规抗菌药物服用,抗生素降阶梯疗法疗效更优,具体体现在炎症控制程度、肺部症状改善方面。

Objective To investigate the clinical efficacy of antibiotics deescalation therapy for severe pneumonia.Methods The patients with severe pneumonia in our hospital were divided into study group(30 cases,receiving antibiotic staircase therapy)and control group(30 cases,receiving routine antibiotic treatment).White blood cell and CRP in 72 hours before and after treatment;improvement time of clinical symptoms;effective rate of severe pneumonia;adverse drug reactions in the two groups during medication were compared.Results Before treatment,the leukocyte count and CRP in the study group and the control group were [(18.68 ± 2.47)×10^9/L,(28.82 ± 3.35)mg/L],[(18.54 ± 2.69)×10^9/L,(29.01 ± 3.16)mg/L)],respectively,there was no significant difference(P>0.05).Leukocyte count and CRP at 72 hours after treatment in the study group and the control group were [(10.28 ± 2.69)×10^9/L,(6.34 ± 2.12)mg/L],[(15.26 ± 3.47)×10^9/L,(10.34 ± 2.58)mg/L],respectively,the difference was statistically significant(P<0.05).There were significant differences in the improvement time of clinical symptoms between the two groups(time of body temperature returning to normal,time of breathing stabilization,time of rale disappearance,time of disease stabilization)(P<0.05).The effective rates of severe pneumonia in the study group and the control group were 100.00% and 83.33%,respectively,the difference was statistically significant(P<0.05).Conclusion Compared with conventional antibiotics,the efficacy of de escalation therapy is better,especially in the degree of inflammation control and improvement of pulmonary symptoms.