美罗培南不同给药方式对重症感染患者疗效的影响

Therapeutic Effects of Different Administration Modes of Meropenem in Patients with Severe Infection

目的探讨美罗培南不同给药方式对重症感染患者疗效的影响。方法选取2017年2月至2019年8月南充市中心医院重症监护病房(ICU)收治的重症感染患者116例作为研究对象,根据美罗培南给药方式不同分为两组,其中对照组56例行常规静脉滴注给药,观察组60例行持续泵注给药。收集患者临床疗效、入院时白细胞计数(WBC)、C反应蛋白(CRP)、体温、全身性感染相关性器官功能衰竭评分(SOFA)、急性生理与慢性健康评分(APACHEⅡ)及不良反应发生情况,分析重症感染患者疗效的影响因素。结果单因素分析结果显示,不同年龄、入院时体温、不良反应发生情况的重症感染患者疗效比较差异无统计学意义(P>0.05)。观察组患者治疗有效率为93.33%,显著高于对照组的76.79%,入院时不同WBC、CRP、SOFA及APACHEⅡ的重症感染患者比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,观察组(使用持续静脉滴注)(OR=0.349,95%CI=0.153~0.689)为重症感染患者治疗有效的保护因素,入院时SOFA≥2分(OR=2.593,95%CI=1.298~3.671)、入院时APACHEⅡ≥20分(OR=2.451,95%CI=1.109~3.496)为危险因素(P<0.05)。结论美罗培南持续静脉滴注为重症感染患者治疗有效的保护性因素,另外入院时SOFA、APACHEⅡ对患者预后有一定的影响,可用于评估重症感染患者的预后。

Objective To explore the effects of different administration methods of meropenem on patients with severe infection.Methods A total of 116 patients with severe infection who were admitted to ICU in Nanchong Central Hospital from February 2017 to August 2019 were selected as the research objects and were divided into 2 groups according to the different modes of administration of meropenem.Among them,56 patients in the control group received conventional intravenous infusion and 60 patients in the observation group received continuous pump injection.The therapeutic effects,white blood cell count in hospital(WBC),C-reactive protein(CRP),body temperature,Systematic Infection Organ Failure Assessment(SOFA),acute physiology and chronic health score(APACHEⅡ),and adverse reactions were collected.The factors influencing the efficacy of severely infected patients were analyzed.Results The results of univariate analysis showed that there was no statistically significant difference in the efficacy of patients with severe infections according to patient age,body temperature at admission,and adverse reactions(P>0.05).The total effective rate of patients in the observation group was 93.33%,which was significantly higher than 76.79%in the control group.The difference in WBC,CRP,SOFA,and APACHEⅡat the time of admission for severely infected patients was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that the observation group(using continuous intravenous drip)(OR=0.349,95%CI=0.153-0.689)was an effective protective factor for the treatment of severely infected patients,and SOFA≥2(OR=2.593,95%CI=1.298-3.671),APACHEⅡ≥20(OR=2.451,95%CI=1.109-3.496)at admission were risk factors(P<0.05).Conclusion Meropenem continuous intravenous infusion is an effective protective factor for the treatment of severely infected patients.In addition,SOFA and APACHEⅡat the time of admission have certain effects on the prognosis of patients and can be used to predict the prognosis of patients with severe infection.