老年慢性肾功能不全合并细菌感染的抗生素治疗分析  

Analysis of antibiotic treatment on elderly patients with chronic renal insufficiency and bacterial infection

作　　者：陈振汉 滕玲[2] 

机构地区：[1]上海市宝山区庙行镇社区卫生服务中心,上海200443 [2]牡丹江医学院第二附属医院老年病科

出　　处：《现代预防医学》2013年第12期2373-2374,F0003,共3页Modern Preventive Medicine

摘　　要：目的探索应用抗生素治疗慢性肾功能不全失代偿期合并下呼吸道感染的老年患者的临床效果和对其肾功能的影响。方法选取某院自2008年5月～2011年10月治疗的60例肾功能不全合并肺部感染的老年患者纳入观察组,同期选取60肾功能正常的老年下呼吸道感染的患者纳入对照组。两组患者应用头孢哌酮进行治疗,观察两组患者的总体治疗效果差异以及观察组患者治疗前后的肾功能血肌酐、尿素氮、尿酸、肌酐清除率水平差异。结果观察组和对照组患者平均治疗时间分别为(10.15±3.23)d和(7.32±2.18)d,差异有统计学意义(P﹤0.05);两组患者的总体治疗效果差异无统计学意义(P﹥0.05),但痊愈率差异有统计学意义(P﹤0.05);观察组治疗前后患者的血肌酐、尿素氮、内生肌酐清除率水平与治疗前比较差异有统计学意义(P﹤0.05)。结论肾功能不全的老年患者一旦发生下呼吸道感染,应用抗生素治疗的难度增大,治疗过程中应密切留意患者的肾功能情况,并合理控制药物用量,一旦出现肾功能衰竭应立即停药,必要时进行血液透析。OBJECTIVE To explore the clinical effect of antibiotic treatment on elderly patients with chronic renal insuffi- ciency and bacterial infection, and its influence on the renal function. METHODS 60 elderly patients with chronic renal failure （the experimental group） and 60 elderly patients with normal renal function （the control group） were chosen, and all patients suffered from lower respiratory tract infection and were treated by Ceftazidime in our hospital from May 2008 to October 2011. The difference of clinical effect and renal function change before and after treatment were observed. RESULTS The average treatment time of experimental group and control group were （10.15±3.23） d and （7.32±2.18） d with a stastical difference （P 〈 0.05） ; There was no statistical difference in overall treatment effect （P 〉 0.05） between two groups, but cure rate between two groups had a stastical difference （P 〈 0.05） ; Besides, the difference of SCr, BUN, and CCr before and after treatment were significant in experimental group （P 〈 0.05）. CONCLUSION Antibiotic treatment on bacterial infection of elderly patients with chronic renal insufficiency is harder than treating normal renal function elderly patients. More attention needs to be paid to them, and once renal insufficiency presents, the drug should be immediately discontinued and hemodialysis could be used if necessary.

关 键 词：抗生素 肾功能不全 老年 头孢他啶 

分 类 号：R453.2[医药卫生—治疗学] R692[医药卫生—临床医学]