抗生素降阶梯治疗对老年重症肺炎的疗效评价

Efficacy evaluation of antibiotic step-down therapy for elderly patients with severe pneumonia

目的探讨抗生素降阶梯治疗对老年重症肺炎的疗效。方法86例老年重症肺炎患者,根据治疗方法的不同分为研究组与对照组,各43例。对照组应用常规抗生素治疗,研究组应用抗生素降阶梯治疗。对比两组治疗效果,D-二聚体、C反应蛋白、降钙素原、前清蛋白水平,住院费用、抗生素使用时间、重症加强护理病房(ICU)住院时间、总住院时间。结果研究组治疗总有效率97.7%高于对照组的83.7%,差异有统计学意义(P<0.05)。治疗后,研究组D-二聚体、C反应蛋白、降钙素原分别为(0.78±0.24)μg/L、(15.88±5.63)mg/L、(1.17±0.04)ng/ml,均低于对照组的(1.44±0.45)μg/L、(22.66±8.66)mg/L、(3.44±0.09)ng/ml,前清蛋白(207.55±30.13)mg/L高于对照组的(173.35±28.78)mg/L,差异均有统计学意义(P<0.05)。研究组ICU住院时间、抗生素使用时间、总住院时间分别为(4.4±2.4)、(11.2±2.1)、(12.1±4.4)d,均短于对照组的(6.8±2.8)、(14.4±9.4)、(15.6±3.6)d,住院费用(7922.4±2432.2)元低于对照组的(11885.2±2855.6)元,差异均有统计学意义(P<0.05)。结论老年重症肺炎的治疗过程当中,抗生素降阶梯治疗效果比较理想,可改善临床指标,应当进一步推广应用。

Objective To discuss the efficacy of antibiotic step-down therapy for elderly patients with severe pneumonia.Methods A total of 86 elderly patients with severe pneumonia were divided into research group and control group by different treatment methods,with 43 cases in each group.The control group was treated with conventional antibiotics,and the research group was treated with antibiotic step-down therapy.The therapeutic effect,D-dimer,C-reactive protein,procalcitonin,prealbumin levels,hospitalization expenses,antibiotic use time,intensive care unit(ICU)hospitalization time,total hospitalization time were compared between the two groups.Results The total effective rate of treatment 97.7%of the research group was higher than 83.7%of the control group,and the difference was statistically significant(P<0.05).After treatment,D-dimer,C-reactive protein,procalcitonin,prealbumin of the research group were(0.78±0.24)μg/L,(15.88±5.63)mg/L and(1.17±0.04)ng/ml respectively,which were lower than(1.44±0.45)μg/L,(22.66±8.66)mg/L and(3.44±0.09)ng/ml of the control group,and prealbumin(207.55±30.13)mg/L was higher than(173.35±28.78)mg/L of the control group,and the difference was statistically significant(P<0.05).The ICU hospitalization time,antibiotic use time and total hospitalization time of the research group were(4.4±2.4),(11.2±2.1)and(12.1±4.4)d respectively,which were shorter than(6.8±2.8),(14.4±9.4)and(15.6±3.6)d of the control group,and hospitalization expenses(7922.4±2432.2)yuan was lower than(11885.2±2855.6)yuan of the control group,and the difference was statistically significant(P<0.05).Conclusion Antibiotic step-down therapy shows ideal therapeutic effect in the treatment of senile severe pneumonia,and it can improve the clinical indicators and should be further promoted and applied.