抗生素降阶梯治疗重症肺炎的临床疗效及安全性

Clinical Efficacy and Safety of Antibiotic Ladder-down Therapy for Severe Pneumonia

目的:探讨抗生素降阶梯治疗重症肺炎的临床疗效及安全性。方法:本次研究纳入2016年8月到2018年11月期间在我院接受治疗的56例重症肺炎患者,将所有研究对象按照住院单双号不同分成2组,对照组(n=28)采用抗生素升阶梯疗法,治疗组(n=28)采用抗生素降阶梯疗法,对比两组的疗效及安全性。结果:与治疗前相比,治疗后对照组和治疗组的D-D、PCT以及CRP值均明显降低(P<0.05),且治疗组的上述检查指标降低幅度大于对照组(P<0.05)。对照组的抗生素静脉用药时间、肺部啰音消失时间、平均住院时间以及感染控制时间均长于治疗组(P<0.05)。对照组的治疗总有效率显著低于治疗组(P<0.05)。对照组的不良反应发生率和气管插管率均明显高于治疗组(P<0.05)。结论:与抗生素升阶梯疗法相比较,采用抗生素降阶梯方法治疗重症肺炎疗效更加明显,有利于显著改善临床症状,降低不良反应发生率和气管插管率,值得临床借鉴和推广。

Objective:To investigate the clinical efficacy and safety of antibiotic step-down therapy for severe pneumonia.Methods:The study included 56 patients with severe pneumonia who were treated in our hospital from August 2016 to November 2018.All the subjects were divided into two groups according to the number of single and even inpatients.The control group(n=28)was treated with antibiotic ladder therapy.The therapeutic effect and safety of two groups were compared.Results:Compared with those before treatment,the values of D-DG PCT and CRP in the control group and the treatment group were significantly decreased after treatment(P<0.05).The decrease of the above indexes in the treatment group was higher than that in the control group(P<0.05).The time of intravenous administration of antibiotics,the time of disappearance of rale,the average time of hospitalization and the time of infection control in the control group were longer than those in the treatment group(P<0.05).The total effective rate of the control group was significantly lower than that of the treatment group(P<0.05).The incidence of adverse reactions and tracheal intubation rate in the control group were significantly higher than those in the treatment group(P<0.05).Conclusion:Compared with antibiotic ladder therapy,antibiotic descending ladder therapy is more effective in the treatment of severe pneumonia,which is beneficial to improve clinical symptoms,reduce the incidence of adverse reactions and reduce the incidence of adverse reactions.The rate of tracheal intubation is worthy of clinical reference and popularization.