32例于重症医学科治疗的重症肺炎患者的疗效分析

Analysis of the effect of 32 patients with severe pneumonia treated in critical medicine department

目的探讨重症医学科重症肺炎患者的治疗方法及其效果。方法32例重症医学科收治的重症肺炎患者,对其病史资料进行回顾性分析,32例患者均采用美罗培南进行抗感染治疗,按照输注方案的不同分为观察组(20例)和对照组(12例)。观察组微量注射泵持续输注4 h,对照组微量注射泵持续输注2 h,在抗感染治疗的基础上两组患者均同时接受机械通气、营养支持等对症治疗。比较两组患者的整体疗效,细菌学疗效,血清白细胞计数、降钙素原、C反应蛋白水平。结果观察组患者总有效率为90.00%,与对照组的83.33%比较,差异无统计学意义(P>0.05)。观察组患者的细菌清除率80.00%明显高于对照组的41.67%,差异有统计学意义(χ^2=4.885,P=0.027<0.05)。治疗前,两组患者的白细胞计数、降钙素原、C反应蛋白水平比较,差异均无统计学意义(P>0.05);治疗后,两组患者的白细胞计数、降钙素原、C反应蛋白水平均较本组治疗前降低,且观察组白细胞计数(7.3±2.3)×10^9/L、降钙素原(0.7±0.2)mg/dl、C反应蛋白(4.8±1.2)mg/L均低于对照组的(9.4±3.2)×10^9/L、(1.5±0.4)mg/dl、(10.6±2.1)mg/L,差异均具有统计学意义(P<0.05)。结论对于重症医学科重症肺炎患者,采用美罗培南作为抗菌药物,并采用低剂量长时间输注方式给药,可有效增强抗菌效果,对于改善患者预后具有十分积极的作用。

Objective To discuss the treatment methods and effects of patients with severe pneumonia in critical medicine department.Methods A total of 32 patients with severe pneumonia treated in critical medicine department all received meropenem for anti-infective treatment,and they were divided into observation group(20 cases)and control group(12 cases)by different infusion regimens.The observation group received continuous infusion of microinjection pump for 4 h,and the control group received continuous infusion of microinjection pump for 2 h.On the basis of anti infection treatment,the patients in both groups received mechanical ventilation,nutritional support and other symptomatic treatment at the same time.The overall efficacy,bacteriological efficacy,serum leukocyte count,procalcitonin and C-reactive protein levels were compared between the two groups.Results The total effective rate was 90.00%in the observation group,which had no statistically significant difference compared with 83.33%in the control group(P>0.05).The bacterial clearance rate 80.00%in the observation group was obviously higher than 41.67%in the control group,and the difference was statistically significant(χ^2=4.885,P=0.027<0.05).Before treatment,there was no statistically significant difference in leukocyte count,procalcitonin and C-reactive protein levels between the two groups(P>0.05).After treatment,the leukocyte count,procalcitonin and C-reactive protein levels in the two groups were lower than those before treatment.The leukocyte count,procalcitonin and C-reactive protein levels were(7.3±2.3)×10^9/L,(0.7±0.2)mg/dl and(4.8±1.2)mg/L in the observation group,which were lower than(9.4±3.2)×10^9/L,(1.5±0.4)mg/dl and(10.6±2.1)mg/L in the control group.Their difference was statistically significant(P<0.05).Conclusion For severe pneumonia patients in critical medicine department,meropenem is used as an antibacterial agent and is administered by low-dose long-term infusion.It can effectively enhance the antibacterial effect and has a very positive effect on improving the prognosis of patients.