摘要
目的 探讨雾化吸入阿米卡星在多重耐药及泛耐药革兰阴性细菌感染的医院获得性肺炎（HAP）患者中的疗效及安全性。方法 选取确诊的多重耐药及泛耐菌细菌感染的HAP患者44例,按随机数字表法分为两组各22例,常规治疗基础上,治疗组予阿米卡星0.2~0.3 g＋沐舒坦15 mg bid雾化治疗,观察组予沐舒坦15 mg bid雾化治疗,疗程2周,监测患者血氧饱和度、血白细胞、临床肺部感染评分及细菌培养的变化,同时对患者治疗好转率、细菌培养阳性率及死亡率进行追踪和分析。结果 治疗组及观察组患者治疗好转率分别为77.27%及72.72%,差异无统计学意义（P〉0.05）,细菌培养阳性率分别为13.64%、45.46%,差异有统计学意义（P〈0.05）;治疗过程中有心率加快、氧饱和度降低等不良反应,仅1例患者出现声嘶,无严重不良事件。结论 雾化吸入阿米卡星可以作为临床上治疗多重耐药细菌感染的HAP患者的辅助治疗措施。
Objective To analyze the efficacy and safety of nebulization of amikacin joint intravenous anti -infection treatment for hospital-acquired pneumonia with multi-resistant and pan-resistant gram-negative bacteria infection .Methods Fortyf-our diagnosed hospital-acquired pneumonia with multiple and extensive drug-resistant bacteria infection were selected .The patients were divided into two groups .Based on conventional intravenous anti-infection treatment , treatment group was given atomization inhalation treatment of amikacin 0.2 ~0.3 g and mucosolvan 15 mg bid while observational group received atomization inhalation treatment of mucosolvan 15 mg bid,two weeks.The blood oxygen saturation ,blood leukocytes,clinical pulmonary infection score and changes in bacterial culture were monitored .At the same time ,improvement rate ,bacterial culture positive rate and mortality rate were followed up and analyzed .Re-sults The improvement rates in the treatment group and the observational group were 77.27%and 72.72%respectively （ P〉0.05 ） . The bacterial culture positive rates in the two groups were 13.64% and 45.46%.The differences were statistically significant （ P 〈0.05 ） .During period of the treatment ,there were adverse reactions such as fast heart rate and reduced blood oxygen saturation ,but no serious adverse events were found with only 1 patient with hoarseness .Conclusion Atomization inhalation of amikacin can be used as an assisted clinical treatment for multiple drug-resistant bacteria infection in patients with hospital acquired pneumonia .
出处
《实用医院临床杂志》
2016年第4期114-117,共4页
Practical Journal of Clinical Medicine
关键词
医院获得性肺炎
多重及泛耐药细菌
雾化
阿米卡星
Hospital acquired pneumonia
Multiple and extensive drug-resistant bacteria
Atomization inhalation
Amikacin
