美罗培南不同输注方案对老年获得性重症肺炎患者动脉血气分析参数及预后的影响  

Influence of different infusion regimens of meropenem on arterial blood gas analysis parameters and prognosis in the treatment of severe acquired pneumonia in the elderly

作　　者：张磊[1] 陈汉明[1] 黄典[1] 

机构地区：[1]柳州市人民医院重症医学科,广西柳州545006

出　　处：《海南医学》2017年第23期3823-3826,共4页Hainan Medical Journal

摘　　要：目的探讨不同美罗培南输注方案对老年获得性重症肺炎患者动脉血气分析参数及预后的影响。方法将2013年6月至2015年6月于柳州市人民医院重症医学科治疗的老年获得性重症肺炎患者86例按随机数表法分为观察组和对照组各43例,对照组输注时间为2 h,观察组输注时间为4 h,疗程均为7 d,比较两组患者的临床疗效、抗菌疗效、血气指标及不良反应。结果观察组患者的临床治疗总有效率为93.0%,明显高于对照组的69.8%,细菌清除率为69.8%,明显高于对照组的46.5%,差异均有统计学意义(P<0.05);治疗后两组患者的血气指标均有所改善,但观察组患者的动脉血二氧化碳分压(Pa CO2)、乳酸(Lac)值明显低于对照组,动脉血氧分压(Pa O2)、p H值、最大口腔吸气压(MIP)及最大口腔呼气压(MEP)明显高于对照组,差异均有统计学意义(P<0.05);观察组患者的不良反应发生为9.3%,低于对照组的16.3%,但差异无统计学意义(P>0.05)。结论将美罗培南输注时间改为4 h,不仅提高老年获得性重症肺炎患者的动脉血气,提高治疗效果,同时能够改善患者预后。Objective To observe of the influence of different infusion regimens of meropenem on arterial bloodgas analysis parameters and prognosis in the treatment of severe acquired pneumonia in the elderly. Methods A total of 86 elderly patients with severe acquired pneumonia, who admitted to Department of Critical Care Medicine of Liuzhou Peo-ple＇s Hospital from June 2013 to June 2015, were selected and divided into the observation group and control group, with43 cases in each group. The infusion time was two hours for the control group and four hours for the observation group.The course of treatment of the two groups was 7 days. The clinical effect, antibacterial effect, arterial blood gas analysisparameters, adverse reactions and prognosis of the two groups were compared. Results The total effective rate and anti-bacterial effect of the observation group were respectively 93.0% and 69.8%, which were significantly higher than 69.8%and 46.5% of the control group（P〈0.05）. After the treatment, the arterial blood gas analysis parameters in the two groupswere improved; the partial pressure of carbon dioxide（Pa CO2） and artery and lactic acid（Lac） of the observation group weresignificantiy lower than those in the control group（P〈0.05）; the partial pressure of dioxide（Pa O2）, p H value, maximum in-spiratory pressure（MIP） and maximal expiration pressure（MEP） of the observation group were significantiy higher thanthose in the control group（P〈0.05）. The adverse reactions was 16.3% in the control group versus 9.3% in the observationgroup（P〈0.05）. Conclusion The four-hour infusion time can significantly improve blood gas, which not only can in-crease arterial blood gas and therapeutic effect, but also can improve the prognosis of elderly patients with severe acquired pneumonia.

关 键 词：美罗培南 重症肺炎 血气分析 预后 

分 类 号：R563.1[医药卫生—呼吸系统]