首选碳青霉烯类药物对重症肺炎患者的临床疗效及经济学评价

The clinical efficacy and economic evaluation of the first choice carbapenem drugs for patients with severe pneumonia

目的:本文旨在研究首选碳青霉烯类药物治疗的重症肺炎患者,其临床疗效及经济学评价。方法:选取2019年1月~ 2020 年1 月收治入我院重症医学科的重症肺炎患者98例作为研究对象。根据患者治疗是否首选碳青霉烯类药物,将患者分为首选碳青霉烯类药物组(病例组,N=52)和非首选碳青霉烯类药物组(对照组,N=46),对比两组患者用药后的临床疗效、细菌学评价以及经济学评价。结果:治疗前两组患者PaO2、PaCO2、pH和PCT比较无明显统计学差异。抗菌治疗后患者各项评分指标均有不同程度改善,病例组病情改善情况优于对照组。治疗结束后,病例组的各标志物水平较治疗前明显降低,且显著低于对照组。对照组经治疗后32株致病菌被清除,病例组36株致病菌被清除。病例组鲍曼不动杆菌、铜绿假单胞菌以及肺炎克雷伯菌的清除率均高于对照组。对照组总有效率60.71%。病例组总有效率78.57%。病例组疗效明显优于对照组。对照组患者使用抗生素的时间、ICU住院时间和ICU住院费用均显著高于病例组。结论:重症肺炎患者首选碳青霉烯类药物治疗在获得较好临床疗效的情况下,具有更低的治疗成本,值得临床规范化推广应用。

Objective This article aims to study the clinical efficacy and economic evaluation of patients with severe pneumonia who are the first choice for carbapenem drugs.Methods 98 patients with severe pneumonia admitted to the Department of Intensive Care Medicine of our hospital from January 2019 to January 2020 were selected as the research objects.According to whether the patients prefer carbapenems for treatment,the patients are divided into the preferred carbapenems group (case group,N=52) and the non-preferred carbapenems group (control group,N=46),the clinical efficacy,bacteriological evaluation and economic evaluation of the two groups of patients after medication were compared.Results There was no significant difference in PaO_(2)、PaCO_(2)、pH和PCT between the two groups of patients before treatment.After antibacterial treatment,the patients’ scores improved to varying degrees,and the improvement of the condition of the case group is better than the control group.After treatment,the levels of markers in the case group were significantly lower than before treatment,and were significantly lower than those in the control group.After treatment in the control group,32 pathogenic bacteria were cleared,and 36 pathogens in the case group were cleared.The clearance rates of Acinetobacter baumannii,Pseudomonas aeruginosa and Klebsiella pneumoniae in the case group were higher than those in the control group.The total effective rate of the control group was 60.71%.The total effective rate of the case group was 78.57%.The curative effect of the case group was significantly better than that of the control group.The time of antibiotic use,ICU hospitalization time and ICU hospitalization expenses of the control group were significantly higher than those of the case group.Conclusion Carbapenem drugs are the first choice for patients with severe pneumonia,and they have lower treatment costs and are worthy of clinical standardized promotion and application when they have obtained better clinical effects.