摘要
目的使用降阶梯方案治疗发热隔离病区危重症新型A/H1N1流感,评价其疗效。方法选取2009年10月26日—2010年2月26日本院发热隔离病区危重症新型A/H1N1流感患者6例,随机分为2组,传统治疗组3例以头孢夫辛钠+左氧氟沙星为经验性治疗方案,降阶梯治疗组3例以亚胺培南/西司他丁+去甲万古霉素作为经验性治疗方案,比较2组患者的初始治疗恰当率、感染控制率和感染控制所需时间。结果降阶梯治疗组和传统治疗组的初始治疗恰当率分别为100%和33%(P<0.01),治疗有效率分别为100%和33%(P<0.05),感染控制所需时间分别为(7.3±2.8)d和(13.4±4.3)d(P<0.05)。结论对于危重症新型A/H1N1流感使用降阶梯治疗可获得较好疗效。且亚胺培南/西司他丁+去甲万古霉素作为危重症新型A/H1N1流感起始经验性用药,可防止病情迅速恶化,随后根据病原学及临床效果换用针对性抗菌药物的降阶梯疗法有其合理性。
Objective It is to observe the curative effect of de-escalation therapy for severe A/H1N1 influenza in the department of severe A/H1N1 influenza.Methods 6 patients of severe A/H1N1 influenza were selected and randomly divided into two groups.In traditional group,Cefuroxime Sodium and levofloxacin were given as empirically therapy;while in de-escalation group,Imipenem with Cilastatin and Norvancomycin were specially given as empirically therapy.The adequate rate of initial therapy,infection controlled rate and the days from the treatment beginning to the infection controlled were compared between both groups.Results Between de-escalation group and traditional group the adequate rate of initial therapy was 100% VS 33.33% respectively（P〈0.01）.The infection controlled rate was 100% VS 33.33% respectively（P〈0.05）.The days from the treatment beginning to the infection controlled was（7.3±2.8） days VS（13.4±4.3） days respectively（P〈0.05）.Conclusion The de-escalation therapy for severe A/H1N1 influenza can get better curative effect.Imipenem with Cilastatin and Norvancomycin could be of first choice to prevent disease worse and then it＇s reasonable to change the antibiotic by bacterial aetiology and clinical effect.
出处
《现代中西医结合杂志》
CAS
2010年第18期2221-2222,2236,共3页
Modern Journal of Integrated Traditional Chinese and Western Medicine
