亚胺培南西司他丁治疗重症肺炎患者的观察.pdf

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1、临床肺科杂志2010年5月第15卷第5期625亚胺培南西司他丁治疗重症肺炎患者的观察施炜熊伟【摘要】目的评价亚胺培南西司他丁治疗重症肺炎患者的临床疗效及安全性。方法以42例重症肺炎患者为研究对象，给予亚胺培南西司他丁0．5或1g，q8h静滴，观察重症肺炎患者的临床和不良反应。结果应用亚胺培南西司他丁治疗重症肺炎患者的疗效明显胜于治疗前；痰液病原体的清除率为87．5％；胸部cT肺部炎性渗出病灶较前明显吸收；34例存活的重症肺炎患者未见不良反应。结论亚胺培南西司他丁对重症肺炎患者有良好的治疗效果。【关键词】亚胺培南西司他丁；重症肺炎；治疗ClinicalobservationofTien

2、amintreatingpatientswithseverepneumoniaSH1Wei．XIONGWei．DepartmentofRespiratoryDisease，AnqingMunicipalHospital，AnqingCity，AnhuiProvince246003，China【Abstract】ObjectiveToevaluateclinicalefficacyandsafetyofTienamintreatingpatientswithseverepneumonia．Methods42casesofpatientswithseverepneumoniawerese

3、lectedassubjectswhoweregivenTienam0．5or1g．q8hintravenouslyfor9．5(±2．5)days．Bodytemperaturechangewasobserved，selTlmhigh-sensitivityC—reactiveprotein，bloodroutinetest，alanineanlinotransferase(AI)，aspartateaminotransferase(AST)，bloodureanitrogen(BUN)，creatinine(Cr)，a~efialbloodoxygenpressure(PaO2)

4、andoxygen—ationindex(PaO2／FiO2)weredetectedbeforeandafterthetreatment，sputumculturewascarriedout，chestCTwasreviewedinthesub—jects．Differencesofrelatedvalueswerecomparedbeforeandafterthetreatment，adversereactionofTienamwasobservedinthesubjects．ResultsThemainfindingswereasfollowes：SerumhJgh—sensi

5、tivityC—reactiveproteinconcentrationafterthetreatment[(9．1±3．1)mg／L]wassignificantlylowerthanthatbeforethetreatment[(97．64-21．3)mg／L]；totalnumberofperipheralwhitebloodceilsafterthetreat—nlent[(5．84-2．5)×10／L]wassignificantlylowerthanthatbeforethetreatment[(18．3±6．2)×10／L]；PaO2afterthetreatment[

6、(85．2±10．2)mmHg]wassignificantlyhigherthanthatbeforethetreatment[(52．3±14．4)mmHg]；PaO2／FiO2afterthetreatment[(411．6±57．1)mmHg]wassignificantlyhigherthanthatbeforethetreatment[(265．64-29．3)mmHg]；allwithobviouslystatisticalsig—nificanceindifferences(P<0．01)forpatientswithseverepneumonia．Therewere

7、nostatisticaldifferences(尸>0．05)onA，AST，BUNandCrbeforeandafterthetreatment．Sputumpathogenclearanceratewas87．5％．InflammatoryexudationinlungsofchestCTwereobvi-ous

8、yabsorbedafterthetreatment．Noadversereactionwasobservedin34casesofsur