摘要
目的研究COPD合并肺部感染（PI）病原分布及其治疗策略。方法选择2010年4月至2012年12月我院收治的106例COPD合并PI患者作为观察对象，随机分为观察组和对照组，每组各53例。两组患者均进行痰培养以及药敏检测，参照痰培养及药敏实验结果对症用药，观察组在此基础上给予舒利迭吸入剂；对比两组不同方法用药疗效。结果对患者进行痰培养并观察菌株分布情况，结果显示，两组患者感染菌种差异无统计学意义（x^2=0．314，P〉0．05），且主要致病菌均为革兰阴性菌族（gram—negativebacterium，GNB）以及革兰阳性菌族（gram—positivebacterium，GPB）。其中GNB为60．4％（64／106），GPB为32．1％（34／106），此外还有少数真菌6．60％（7／106）。大部分GNB对于亚胺硫霉素比较敏感，其敏感率为81．3％，其次是丁胺卡那，敏感率为73．4％，最次为头孢他啶仅有3．13％。GPB对于万古霉素比较敏感，其敏感率为94．1％，其次为亚胺硫霉素，敏感率为88．2％。其中亚胺硫霉素对两种菌种敏感率均较高，分别为81．3％和88．2％。观察组有效率为96．22％（51／53），显著高于对照组的71．70％（38／53），差异有统计学意义（x^2=11．840，P〈O．01）。结论在深部痰培养以及药敏实验的基础上对症治疗的同时，给予舒利迭吸入剂，可提高COPD合并PI的临床治疗疗效。
Objective To study the pathogen distribution and treatment strategies of chronic obstructive pulmonary disease （COPD） complicated with pulmonary infection （PI）. Methods One hundred and six cases of COPD patients with PI from April 2010 to December 2012 in our hospital were selected as observation objects, and were randomly divided into observation group and control group,each group had 53 cases. Observation group were given sputum culture and drug sensitivity test, according to sputum culture and drug sensitive test results symptomatic medication. Control group according to the clinical experience with drugs. Compared two groups of different methods of drug efficacy. Results The patients were given sputum culture and observed the distribution, the results showed, the main pathogens were gram negative bacteria group （GNB） and gram positive bacteria group （GPB）. GNB was 58.49% （31/53） GPB was 33.96% （18/53）. Most of the GNB element was sensitive to imipenem mold, the sensitivity rate was 83.87 %, followed byamikacin, the sensitivity rate was 74.19%, most of the time only was 3.23 % forceftazidime. GPB was sensitive to vancomycin, the sensitivity rate was 94.44 %, followed by imipenem, the sensitivity rate was 88.89%. The imipenem against twostrains sensitive rate was higher, respectively was 83.87%0,88.89 %. Observation group was 96.22% （51/53）, significantly higher than control group of 71.70% （38/53）, the difference was statistically significant （ x^2 = 11. 840, P 〈0.01 ）. Conclusions Sputum culture and drug sensitive test of deep,the corresponding drugs in the treatment of COPD with PI,have curative effect.
出处
《国际呼吸杂志》
2014年第5期351-353,共3页
International Journal of Respiration
关键词
慢性阻塞性肺疾病
肺部感染
病原分析
治疗策略
Chronic obstructive pulmonary disease
Pulmonary infection
Pathogenic analysis
Treatment strategies
