摘要
目的观察降阶梯抗生素治疗在老年重症肺炎患者中的应用效果。方法选取2017年6月-2019年6月广州市番禺区中心医院急诊科收治的老年重症肺炎患者98例,采用随机数字表法分为观察组和对照组,各49例。在基础治疗上,对照组接受传统抗生素治疗,观察组接受抗生素降阶梯治疗,2组均连续治疗10 d。比较2组患者治疗效果,临床指标[症状(咳嗽、肺部湿啰音)消失、体温复常、维持机械通气]相关时间及住院时间,比较2组患者治疗前后炎性指标[白细胞(WBC)计数、C反应蛋白(CRP)、血清降钙素原(PCT)]水平。结果观察组患者治疗总有效率为97.96%,高于对照组的83.67%(χ^(2)=4.404,P=0.031);观察组咳嗽、肺部湿啰音消失时间、体温复常时间、维持机械通气时间及住院时间均短于对照组(P<0.01);治疗10 d后,2组WBC计数及CRP、PCT水平均较治疗前降低,且观察组低于对照组(P均<0.01)。结论降阶梯抗生素治疗在老年重症肺炎患者中的应用效果佳,可有效改善患者症状,降低炎性因子水平,值得临床推广应用。
Objective To observe the application effect of descending ladder antibiotic therapy in elderly patients with severe pneumonia.Methods Ninety-eight elderly patients with severe pneumonia treated in the emergency department of Panyu District Central Hospital of Guangzhou from June 2017 to June 2019 were selected.The patients were randomly divided into observation group and control group,with 49 cases in each group.On the basis of routine treatment,the control group was treated with traditional antibiotics and the observation group was treated with descending ladder antibiotic treatment.Both groups were treated for 10 days.The treatment effect,related time of clinical indexes(disappearance of symptoms such as cough and lung wet rale,normalization of body temperature,maintenance of mechanical ventilation)and length of hospital stay were compared between the two groups,as well as the levels of inflammatory indexes(WBC count,CRP and PCT)before and after treatment.Results The total effective rate of the observation group was 97.96%,higher than 83.67%of the control group(χ^(2)=4.404,P=0.031).The disappearance time of cough and lung wet rale,the return time of body temperature,the time of maintaining mechanical ventilation and the length of hospital stay in the observation group were shorter than those in the control group(P<0.01).After 10 days of treatment,the WBC count,CRP and PCT levels in the two groups were lower than those before treatment,and the levels in the observation group were lower than those in the control group(P<0.01).Conclusion The application effect of descending ladder antibiotic therapy in elderly patients with severe pneumonia is good.It can effectively improve patients′symptoms and reduce the level of inflammatory factors.It is worthy of clinical application.
作者
湛振业
罗雅洁
蔡海荣
蔡惠铃
ZHAN Zhenye;LUO Yajie;CAI Hairong;CAI Huiling(Panyu District Central Hospital,Guangdong Province,Guangzhou 511486,China)
出处
《临床合理用药杂志》
2022年第2期11-13,17,共4页
Chinese Journal of Clinical Rational Drug Use
基金
广州市番禺区科技医疗卫生项目(No:2020-Z04-067)。
关键词
老年重症肺炎
降阶梯抗生素治疗
治疗效果
Senile severe pneumonia
Descending ladder antibiotic therapy
treatment effect
