SIPS评分指导急诊抗菌药物应用的临床研究

Clinical Study on SIPS Score Guiding the Application of Antibiotics in Emergency

目的探讨SIPS评分指导急诊抗菌药物应用的可行性和有效性,为急诊医生应用抗菌药物提高更多的临床客观评价指标。方法选取2017年7月至2018年6月本院急诊科收治的可疑呼吸系统及腹腔感染患者148例,根据入院日期单双号随机分为观察组(n=74)与对照组(n=74),观察组应用SIPS评分决定是否使用抗菌药物,≥14分患者加用抗生素,对照组根据国家治疗指南标准和医生经验使用抗菌药物治疗,比较两组抗生素使用情况及临床疗效。结果观察组治疗总有效率显著高于对照组(P<0.05)。观察组抗菌药物使用率、抗菌药物使用时间、治疗时间、抗菌药物费用显著少于对照组(P<0.05)。观察组治疗后的WBC、hs-CRP水平及SIPS评分显著低于对照组(P<0.05)。结论应用SIPS评分指导急诊抗菌药物的使用,可促进抗菌药物的合理化使用,减少抗菌药物的耐药,提高患者的临床治疗效果,减轻患者的炎症状态,有利于缩短患者的治疗时间,减少治疗费用。

Objective To explore the feasibility and effectiveness of SIPS score in guiding the use of antibiotics in emergency department, and to improve more objective clinical evaluation indexes for the use of antibiotics in emergency department. Methods 148 patients with suspicious respiratory and abdominal infections admitted to emergency department of our hospital from July 2017 to June 2018 were randomly divided into observation group(n=74) and control group(n=74) according to the admission date. The observation group used SIPS score to decide whether to use antibiotics or not, and the control group used antibiotics according to the national treatment guidelines and doctors’ experience. Bacterial drug treatment, the use of antibiotics and clinical efficacy of the two groups were compared. Results The total effective rate of the observation group was significantly higher than that of the control group(P<0.05). The usage rate of antibiotics, the time of using antibiotics, the treatment time and the cost of antibiotics in the observation group were significantly less than those in the control group(P<0.05). The levels of WBC, hs-CRP and SIPS in the observation group were significantly lower than those in the control group(P<0.05). Conclusion Using SIPS score to guide the use of antibiotics in emergency department can promote the rational use of antibiotics, reduce antibiotic resistance, improve the clinical therapeutic effect, alleviate inflammation, shorten the treatment time and reduce the cost of treatment.