老年重症肺炎抗生素降阶梯治疗的临床效果分析

Observation on Efficacy of De-escalation Antibiotic Therapy for Elderly Severe Pneumonia

目的讨论针对老年重症肺炎患者,观察选择抗生素降阶梯方法完成治疗后获得的临床效果。方法整群选择该院2013年2月—2015年2月老年重症肺炎患者84例。通过随机数表法完成老年重症肺炎患者的随机分组。B2组(对照组42例):临床按照常规选择抗生素进行治疗;B1组(观察组42例):临床选择抗生素降阶梯的方法进行治疗。对比两组患者完成治疗后,在治疗总有效率、气管再插管率以及住院时间等相关指标方面表现出的差异。结果组老年重症肺炎患者完成临床治疗后,B1组患者治疗总有效率为95.24%;气管再插管率28.75%;B2组患者治疗总有效率为61.90%;气管再插管率69.05%;B1组在气管再插管率以及治疗总有效率方面,优于B2组老年重症肺炎患者明显(P<0.05)。B2组住院时间为(19.7±3.7)d;抗生素使用时间为(19.5±9.5)d;B1组住院时间为(16.2±4.5)d;抗生素使用时间为(11.3±2.3)d;在患者住院时间以及抗生素使用时间等相关指标方面,B1组明显优于B2组老年重症肺炎患者(P<0.05)。结论对老年重症肺炎患者,临床选择抗生素降阶梯的方法进行治疗,能够有效对患者的疾病情况进行控制,将患者的住院时间有效缩短,将患者的临床治疗效果有效提高,凸显抗生素降阶梯方法的临床应用价值。

Objective To investigate the clinical effect of de-escalation antibiotic therapy for elderly severe pneumonia. Methods84 elderly patients with severe pneumonia in our hospital from February 2013 to February 2015 were selected and randomly divided into B2 group(n=42, the control group) and B1 group(n=42, the observation group). Conventional antibiotic therapy and de-escalation antibiotic therapy were performed in them respectively. The total effective rate, reintubation rate, length of hospital stay and other related indexes were compared between the two groups after treatment. Results After treatment, the total effective rate(95.24% vs 61.90) was significantly higher and the reintubation rate(28.75% vs 69.05%) was significantly lower in the B1 group than in the B2 group, P<0.05. The length of hospital stay [(16.2±4.5) d vs(19.7±3.7) d] was shorter and the duration of antibiotic treatment was less[(11.3±2.3) d vs(19.5±9.5) d] in B1 group than B2 group, P<0.05. Conclusion De-escalation antibiotic therapy for elderly severe pneumonia is worthy of promotion because it can prevent the disease, shorten the length of hospital stay and improve the outcomes.