亚胺培南西司他丁钠治疗重症感染合并多脏器功能不全患者的疗效及其对血乳酸的影响  

Efficacy of imipenem and cilastatin sodium in the treatment of severe infection complicated with multiple organ dysfunction and its effect on blood lactate

作　　者：程向丽[1] 李渊[1] 燕喜娇[1] 张爱芝 张文凯[1] Cheng Xiangli;Li Yuan;Yan Xijiao;Zhang Aizhi;Zhang Wenkai(Department of Critical Care Medicine,the Second Hospital of Shanxi Medical University,Taiyuan,Shanxi 030002,China)

机构地区：[1]山西医科大学第二医院重症医学科,山西省太原030002

出　　处：《中国基层医药》2018年第15期1947-1951,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 探讨应用亚胺培南西司他丁钠治疗重症感染合并多脏器功能不全患者的疗效及其对患者血乳酸（BLA）的影响.方法 选取2012年1月至2017年1月在山西医科大学第二医院进行治疗124例重症感染合并多脏器功能不全患者,按照随机数字表法分为研究组和对照组,每组62例.研究组使用广谱抗生素亚胺培南西司他丁钠进行治疗,对照组使用左氧氟沙星进行治疗.比较两组治疗疗效、细菌清除率、感染控制时间及BLA水平的变化.结果 研究组总有效率为82.26%,对照组为79.03%,两组差异无统计学意义（χ2＝1.187,P＞0.05）;研究组细菌清除率为80.00%,对照组为52.94%,研究组显著高于对照组（χ2＝5.176, P＜0.05）;研究组感染控制时间明显早于对照组[（3.17 ±1.14）d比（5.21 ±1.18）d）,t＝11.579,P＜0.05];开始用药前,两组BLA水平差异无统计学意义（t＝1.879,P＞0.05）,用药后,研究组BLA水平明显升高,高于对照组（t＝12.179,P＜0.05）,停药1 周后,研究组BLA水平逐渐降低,与对照组差异无统计学意义（ t＝1.483,P＞0.05）,另外用药前与停药1周后相比,两组BLA水平差异无统计学意义（t＝1.237,P＞0.05）.结论 亚胺培南西司他丁钠对于重症感染合并多脏器功能不全患者的治疗具有较好的疗效、细菌清除率,能够对感染进行较为及时的控制,且对患者预后有明显影响,可以在临床推广应用.Objective To investigate the curative effect of imipenem cilastatin sodium in the treatment of patients with severe infection complicated with multiple organ dysfunction ,and its effect on blood lactic acid.Methods From January 2012 to January 2017,a total of 124 patients with severe organ failure and multiple organ dysfunction in the Second Hospital of Shanxi Medical University were selected ,and they were randomly divided into study group and control group according to the digital meter method ,with 62 cases in each group.The study group received a broad -spectrum antibiotic imipenem cilastatin sodium treatment , the control group received levofloxacin treatment.The curative effect,bacterial clearance rate,infection control time and the change of BLA level in the two groups were recorded and compared.Results The total effective rate was 82.26%in the study group and 79.03%in the control group,there was no statistically significant difference between the two groups （χ2＝1.187,P＞0.05）.The bacterial clearance rate in the study group was 80.00%,which was significantly higher than 52.94%in the control group（χ2＝5.176,P＜0.05）.The infection control time in the study group was earlier than that in the control group [（3.17 ± 1.14）d vs.（5.21 ±1.18） d）,t ＝11.579,P ＜0.05].Before treatment,there was no statistically significant difference in BLA level between the two groups （t＝1.879,P＞0.05）.After treatment,the BLA level in the study group was significantly higher than that in the control group （t＝12.179,P＜0.05）,the level of BLA in the study group gradually decreased after one week of withdrawal ,which had no statistically significant difference compared with the control group（t＝1.483,P＞0.05）.There was no statistically significant difference in BLA level between the two groups after one week of discontinuation （t＝1.237,P＞0.05）.Conclusion Imipenem and cilastatin sodium has good curative effect and bacterial clearance rate in the treatment of patients with severe i

关 键 词：感染 多器官功能衰竭 抗菌药 乳酸 

分 类 号：R459.7[医药卫生—急诊医学]