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阿米卡星不同给药方式治疗呼吸机相关性肺炎的临床观察
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| 篇名： | 阿米卡星不同给药方式治疗呼吸机相关性肺炎的临床观察 |
| TITLE： | |
| 摘要： | 目的：观察阿米卡星不同给药方式治疗呼吸机相关性肺炎的疗效和安全性。方法：回顾性收集109例呼吸机相关性肺炎患者资料，按给药方式的不同分为观察组（58例）和对照组（51例）。两组患者均给予注射用头孢曲松钠3.0 g，加入0.9％氯化钠注射液100 ml中，静脉滴注，q12 h。在此基础上，对照组患者给予硫酸阿米卡星注射液7.5 mg/kg，每日1次；观察组患者给予硫酸阿米卡星注射液7.5 mg/kg， 加入0.45％氯化钠注射液20 ml，雾化吸入，每日2次。两组疗程均为7 d。观察两组患者治疗前后的临床肺部感染评分（CPIS）、丙氨酸转氨酶（ALT）、血清肌酐（Cr）、氧合指数（PaO2/FiO2）、白细胞介素（IL）-10、IL-6、C反应蛋白（CRP）、肿瘤坏死因子（TNF）-α、治疗后3个月累积死亡率及不良反应发生情况。结果：治疗前，两组患者CPIS评分、ALT、Cr、PaO2/FiO2、IL-10、IL-6、CRP、TNF-α比较，差异均无统计学意义（P＞0.05）。治疗后，两组患者CPIS评分、TNF-α、IL-6、CRP水平均显著低于同组治疗前，且观察组低于对照组，差异均有统计学意义（P＜0.05）；两组患者治疗前后IL-10水平比较差异无统计学意义（P＞0.05）。观察组患者PaO2/FiO2及对照组ALT、Cr、PaO2/FiO2均显著高于同组治疗前，且观察组PaO2/FiO2高于对照组，但观察组ALT、Cr均显著低于对照组，差异均有统计学意义（P＜0.05）。观察组患者治疗后3个月累积死亡率显著低于对照组，差异有统计学意义（P＜0.05）。两组患者治疗期间均未见严重不良反应发生。结论：雾化吸入阿米卡星治疗呼吸机相关肺炎的疗效优于静脉用药，可有效降低患者炎症因子水平和死亡率，且不增加不良反应的发生。 |
| ABSTRACT： | OBJECTIVE： To observe the efficacy and safety of amikacin different administrations in the treatment of ventilator-associated pneumonia. METHODS： Data of 109 patients with ventilator-associated pneumonia were divided into observation group （58 cases） and control group （51 cases） based on different administrations. All patients received 3.0 g Ceftriaxone sodium for injection， adding into 100 ml 0.9％ Sodium chloride injection， intravenously， once every 12 h. Based on it， control group received 7.5 mg/kg Amikacin sulfate injection， once a day. Observation group received 7.5 mg/kg Amikacin sulfate injection， adding into 20 ml 0.45％ Sodium chloride injection， aerosol inhalation， twice a day. The treatment course for both groups was 7 d. Clinical pulmonary infection score （CPIS）， alanine aminotransferase （ALT）， serum creatinine （Cr）， oxygenation index （PaO2/FiO2）， IL-10， IL-6， C-reactive protein （CRP）， tumor necrosis factor （TNF） -α， cumulative mortality after 3 months of treatment and the incidence of adverse reactions before and after treatment in 2 groups were observed. RESULTS： Before treatment， there were no significant differences in the CPIS score， ALT， Cr， PaO2/FiO2， IL-10， IL-6， CRP and TNF-α levels in 2 groups （P＞0.05）. After treatment， CPIS score， TNF-α， IL-6 and CRP levels in 2 groups were significantly lower than before， observation group was lower than control group， the difference was statistically significant （P＜0.05）， and there was no significant difference in IL-10 before and after treatment in 2 groups （P＞0.05）. PaO2/FiO2 in observation group and ALT， Cr and PaO2/FiO2 in control group were significantly higher than before， PaO2/FiO2 in observation group was higher than control group， ALT and Cr were significantly lower than control group， the differences were statistically significant （P＜0.05）. The cumulative mortality after 3 months of treatment in observation group was significantly lower than control group， the difference was statistically significant （P＜0.05）. And there were no severe adverse reactions during treatment. CONCLUSIONS： The efficacy of amikacin by aerosol inhalation is superior to by intravenous infusion in the treatment of ventilator-associated pneumonia， it can effectively reduce inflammatory cytokine levels and mortality rate， do not increase the incidence of adverse reactions. |
| 期刊： | 2016年第27卷第27期 |
| 作者： | 李依，邓磊 |
| AUTHORS： | LI Yi，DENG Lei |
| 关键字： | 呼吸机相关肺炎；阿米卡星；雾化吸入；给药方式；鲍曼不动杆菌 |
| KEYWORDS： | Ventilator-associated pneumonia； Amikacin； Aerosol inhalation； Administration route； Acinetobacter baumannii |
| 阅读数： | 347 次 |
| 本月下载数： | 4 次 |
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