摘要
目的探讨重症监护病房(ICU)重症感染患者治疗中延长美罗培南输液时间的意义。方法收集行美罗培南治疗的住ICU重症感染患者79例,根据美罗培南输液时间分为观察组(将输液时间延长为3 h内输注完毕)和对照组(行单剂量间歇给药,30 min内输注完毕),分别按250 mg/10 min+750/180 min、1 000 mg/30 min给药。记录不良反应,记录给药前及给药后第72 h患者白细胞计数(WBC)、体温,使用序贯衰竭评估法(SOFA)评估病情严重程度,记录观察组治愈率、28 d生存率、ICU内死亡率。结果给药后72 h,观察组WBC计数[(7.11±2.34)×10~9/L]及SOFA评分(4.51±2.43分)均明显低于对照组[(8.92±2.83)×109/L,6.50±2.02分];观察组治愈率(50.00%)、28 d生存率(82.50%)均高于对照组(25.64%,66.67%),ICU内死亡率(10.00%)明显低于对照组(23.08%),差异均有显著性(P<0.05)。观察组不良反应发生率(27.50%)及给药72 h体温(37.02±0.31℃)均与对照组(33.33%,37.56±0.21℃)无显著差异(P>0.05)。结论 ICU重症感染患者延长美罗培南输液时间具有以下优势:(1)有利于控制感染,缓解器官损伤,改善近期生存状态,降低ICU内死亡率;(2)提高整体疗效的同时不增加不良反应,安全性较高。因此值得推广。
Objective To explore the significance of prolonged duration for infusion of meropenum in patients with severe infections in intensive care unit（ ICU）. Methods A total of 79 patients were treated with meropenum for treatment of severe infections in ICU of this hospital,they were divided into observation group（ prolonged infusion completed within 3 h） and control group（ single dose for intermittent administration according to meropenum infusion time,and completed infusion within 30 min）,and the infusion was given according to 250 mg/10 min ＋ 750/180 min,and 1 000 mg/30 min for separate administration. Adverse events were recorded before administration and after administration of the first72 h of patients,white blood cell count（ WBC） and body temperature were recorded before administration of drug and 72 h after the administtration of drug. Sequential failure Assessment Act（ SOFA） had been applied to assess the severity,the cure rate had been recorded in observation group,28 d survival rate and mortality rate in ICU. Results In 72 h after the treatment,WBC count [（ 7. 11 ± 2. 34） × 109/L] and SOFA scores（ 4. 51± 2. 43） in patients of observation group were significantly lower than those of patients in control group [（ 8. 92 ± 2. 83） x 109/L,6. 50 ± 2. 02].The cure rate（ 50. 00%） and 28 d survival rate（ 82. 50%） in patients of observation group were higher than those（ 25. 64%,25. 64%） of patients in control group,and mortality rate（ 10. 00%） in ICU was lower than that（ 23. 08%） of patients in control group,and the difference was significant（ P 〈 0. 05）. The incidence of adverse reactions（ 27. 50%） and temperature for 72 h（ 37. 02 ± 0. 31℃） in observation group were similar to those（ 33. 33%,37. 56 ± 0. 21℃） of control group,and the difference was not significant（ P 〉 0. 05）. Conclusion The prolonged duration for infusion of meropenem in patients with severe infection in ICU has the following advantages：（1） helping control infection and mitigation of the damage of organs,and improvement in recent living conditions and reducing the mortality rate of ICU;（2） Improvement in overall efficacy without increasing side effects,with high safety,hence it is worthy to be promoted.
出处
《临床和实验医学杂志》
2017年第16期1659-1662,共4页
Journal of Clinical and Experimental Medicine
关键词
重症感染
美罗培南
输液时间
疗效
Severe infection
Meropenem
Infusion time
Efficacy
