替加环素治疗泛耐药鲍曼不动杆菌所致呼吸机相关性肺炎的临床疗效分析

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1、授予单位代码10089学号或申请号20122046蚵妗(£搿大？HebeiMedicalUniversity硕士学位论文科学学位替加环素治疗泛耐药鲍曼不动杆菌所致呼吸机相关性肺炎的临床疗效分析研究生：张旭导师：阎锡新教授专业：内科学二级学院：第二医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师（或指导小组）的指导下，由本人独立完成。本学位论文研究所获得的研究成果，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文，第一署名为单位河北医科大学，试验

2、材料、原始数据、申报的专利等知识广权均归河北医科大学所有。否则，承担相应法律责任。研究生签名：导师签]级学院领导盖章2^7^〉月—日河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等‘掉#外，文中不包含其他人已经发表或撰写的研究成果’指导教师对此进行了审定。本论文由本人独立撰写，文责自负。”目录中文摘要·············································································1英文摘要·····

3、········································································4英文缩写·············································································8研究论文替加环素治疗泛耐药鲍曼不动杆菌所致呼吸机相关性肺炎的临床疗效分析前言·············································································9材料

4、与方法····································································10结果·············································································12附表·············································································15讨论····································

5、·········································21结论·············································································25参考文献·······································································25综述多耐药鲍曼不动杆菌所致呼吸机相关性肺炎的进展··············27致谢······························

6、·····················································37个人简历·············································································38中文摘要替加环素治疗泛耐药鲍曼不动杆菌所致呼吸机相关性肺炎的临床疗效分析摘要近些年来，鲍曼不动杆菌所引起的临床感染越来越多，无论是感染的程度还是感染的部位都呈上升趋势，给感染控制带来了极大困难。鲍曼不动杆菌（Acinetobacterbaumanii，Ab）是一类革兰氏

7、阴性菌，为条件致病菌。它广泛的存在于医疗环境中，且有着较强的生存力及传播性。并随着大量的新型抗生素的问世及广泛应用，使Ab在医院获得性感染中的感染率及耐药率逐年上升，与此同时，Ab的耐药谱也发生着惊人的改变，出现了多重耐药（extensivelydrugresistanceacinetobacterbaumanii,XDR-Ab）或“全耐药”的鲍曼不动杆菌(Pandrugresistantacinetobacterbaumanii,PDR-Ab)。从国内外对鲍曼不动杆菌在医院内感染的分布趋势看，各类重症监护病房中的Ab感染率最高，其中以呼吸

8、科重症监护室为首。Ab最常见的感染部位是肺部，并成为呼吸机相关肺炎的重要致病菌。呼吸机相关性肺炎（Ventilator-associatedPneumonia,VAP）是指患者机