摘要
目的评价抗菌药物降阶梯疗法联合支气管肺泡灌洗术治疗急性脑梗死合并肺部感染患者的疗效,为合理用药提供依据。方法将2012年10月-2013年10月95例急性脑梗死合并肺部感染患者,随机分为观察组48例、对照组47例,观察组采用抗菌药物降阶梯疗法联合支气管肺泡灌洗术治疗,对照组采用常规抗菌药物治疗联合支气管肺泡灌洗术治疗,分别观察其临床疗效、细菌清除率、肺部感染吸收天数、入住神经内科重症监护病房(NICU)天数。结果观察组患者治疗有效率及细菌清除率为93.75%及90.48%,明显高于对照组的65.96%及61.67%,差异有统计学意义(P<0.05);观察组平均肺部感染吸收时间和平均住NICU时间为(6.9±1.7)d和(12.6±4.1)d,明显少于对照组(12.4±1.9)d和(17.8±3.7)d,差异有统计学意义(P<0.05)。结论以降阶梯疗法联合支气管肺泡灌洗术为基础的局部与全身抗菌药物联合治疗,是治疗急性脑梗死合并肺部感染的有效方法。
OBJECTIVE To evaluate the effect of de‐escalation therapy of antimicrobial agents combined with bron‐choa‐lveolar lavage in the treatment of acute cerebral infarction complicated with pulmonary infections ,so as to provide basis for the rational use of antibiotics .METHODS From Oct .2012 to Oct .2013 ,95 patients with acute cerebral infarction complicated with pulmonary infections were randomized divided into two groups .The observa‐tion group with 48 cases received the de‐escalation therapy of antimicrobial agents combined with bronchoalveolar lavage ,while the control with 47 cases received routine therapy of antimicrobial agents combined with bronchoal‐veolar lavage .The effective rate ,the bacteria1 eradication rate ,the average time of pneumonia absorption and the average time of NICU stay between the two groups were compared and analyzed .RESULTS The effective rate and the bacteria1 eradication rate in observation group were significantly higher than those in control group（93 .75% vs 65 .96% ,90 .48% vs 61 .67% ） （P〈0 .05） .The average time of pneumonia absorption and NICU stay in observa‐tion group were significantly shorter than those in control group（6 .9 ± 1 .7 vs 12 .4 ± 1 .9 ,12 .6 ± 4 .1 vs 17 .8 ± 3 . 7） （P〈 0 .05） .CONCLUSION The de‐escalation therapy of antimicrobial agents combined with bronchoalveolar lavage was an effective method for the treatment of acute cerebral infarction complicated with pulmonary infec‐tions .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第20期4679-4681,共3页
Chinese Journal of Nosocomiology
基金
山东省卫生厅基金资助项目(JB2011卫-3-28-2)
关键词
急性脑梗死
肺部感染
抗菌药物
降阶梯疗法
支气管肺泡灌洗术
Acute cerebral infarction
Pulmonary infections
Antibiotics
De-escalation therapy
Bronchoalveolar lavage
