摘要
目的探讨延长美罗培南给药时间法治疗脓毒性休克的疗效。方法选择2012年1月至2014年3月被诊断为脓毒性休克的ICU住院患者143例,治疗前按随机数字法分为延长时间组71例,常规给药组72例,延长时间组患者采用美罗培南1 g,静脉滴注,q8h,每次以输液泵控制输注时间为3 h;常规给药组患者采用美罗培南1 g,静脉滴注,q8h,每次以输液泵控制输注时间为30 min。其他治疗方法相同。观察两组患者的机械通气时间、抗生素使用天数、ICU住院时间、降钙素原(PCT)水平、APACHEⅡ评分、不良反应及28 d病死率。结果延长时间组抗生素使用天数[(8.4±2.3)d vs(12.1±2.2)d]、ICU住院时间[(9.5±2.2)d vs(12.4±2.1)d]及28 d病死率(11.27%vs 16.67%)优于常规给药组(P<0.05),且降钙素原(PCT)水平、APACHEⅡ评分改善更大(P<0.05),机械通气时间及不良反应发生率两组比较差异无统计学意义(P>0.05)。结论在相同剂量下,采用延长给药时间方法,可使美罗培南治疗脓毒性休克的疗效更佳。
Objective To explore the clinical efficacy of extending infusion time of meropenem in the treatment of septic shock. Methods One hundred and forty-three hospitalized patients with septic shock in Inten-sive Care Unit from Jan. 2012 to Mar. 2014 were enrolled. Before treatment, the patients were randomly divided into two groups. Extended time group （n=71） was treated with 1 g meropenem, q8h, intravenous infusion, and each infu-sion pump was within 3 h. Conventional treatment group （n=72） was treated with 1 g meropenem, q8h intravenous infusion, and each infusion pump was within 30 min. The mechanical ventilation time, time of antibiotic use, length of ICU stay, APACHEⅡ score, serum procalcitonin level, adverse reactions and 28 d mortality in the two groups were observed. Results Time of antibiotic use [（8.4 ± 2.3） d vs （12.1 ± 2.2） d], length of ICU stay [（9.5 ± 2.2） d vs （12.4±2.1） d], 28 d mortality （11.27%vs 16.67%）, APACHEⅡscore and serum procalcitonin level reduction in the extended time group were significantly better than those in the conventional treatment group （P〈0.05）. The inci-dence of adverse reactions and mechanical ventilation time did not show significant difference between the two groups （P〉0.05）. Conclusion Extending infusion time of meropenem is superior to conventional treatment and should be recommended as empirical therapy against septic shock.
出处
《海南医学》
CAS
2014年第24期3622-3624,共3页
Hainan Medical Journal
