延长美罗培南输液时间治疗脓毒症休克合并急性肾功能不全患者的临床效果  

Clinical effects of prolonging meropenem infusion time on septic shock patients with acute renal insufficiency

作　　者：付海英 黄马玉[1] FU Haiying;HUANG Mayu(Department of Emergency,Tongren Hospital Affiliated to Shanghai Jiaotong University Medical College,Shanghai 300336,China)

机构地区：[1]上海交通大学医学院附属同仁医院急诊科,上海300336

出　　处：《中国急救复苏与灾害医学杂志》2020年第9期1081-1084,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：上海市自然科学基金(编号:CNKW2018Y03)。

摘　　要：目的 探讨延长美罗培南输液时间治疗脓毒症休克合并急性肾功能不全患者的效果.方法 选取2015年2月—2018年10月在上海交通大学医学院附属同仁医院急诊科治疗的脓毒症休克合并急性肾功能不全患者78例,根据美罗培南输液时间情况分为观察组(n=40)和对照组(n=38),其中对照组给予美罗培南1.0 g,q8 h,输注30min,观察组给予美罗培南0.5g,q8h,输注3h,观察两组治疗疗效、序贯器官衰竭(sequential organ failure assessment,SOFA)评分、全身炎症反应(systemic inflammatory response score,SIRS)评分等.结果 观察组治疗疗效、细菌清除情况优于对照组(P<0.05),其治疗总有效率和细菌完全清除率分别达到95.00%和80.00%;观察组治疗后SOFA和SIRS评分分别为(3.40±0.98)分和(3.20±0.82)分,明显低于对照组(P<0.05);观察组治疗后血肌酐(serum creatinine,Scr)和尿素氮(blood urea nitrogen,BUN)分别为(203.02±76.42)mmol/L和(39.03±4.15)mmol/L,明显低于对照组(P<0.05);观察组和对照组不良反应率比较差异无统计学意义(P>0.05).结论 延长美罗培南输液时间治疗脓毒症休克合并急性肾功能不全有较好的临床效果,值得临床使用.Objective To explore the clinical effects of prolonging meropenem infusion time on septic shock patients with acute renal insufficiency.Methods 78 dempgraphically and clinically matched patients with septic shock and acute renal insufficiency in Emergency department of Tongren Hospital Affiliated to Shanghai Jiaotong University Medical College were randomly divided into 2 groups:control group(n=38)given 30 minutes'infusion of meropenem 1.0 g,q8h,with a treatment course of I week,and observation group given 3 hours'infusion of meropenem 0.5g,q8h,with a treatment course of I week.After the treatment fast peripheral blood samples were collected to test the levels of serum creatinine(Scr)and blood urea nitrogen(BUN).Sequential organ failure assessment(SOFA)score and systemic inflammatory response score(SIRS)were used to compare the clinical effects.Results The total effective rate of the observation group was 95.00%,significantly higher than that of the control group(81.58%,P<0.05).The complete bacterial clearance rate of the observation group were 92.50%,significantly higher than that of the control group(81.58%,P<0.05).The SOFA score of the observation group after treatment were(3.40±0.9),significantly lower than that of the con-trol group[(5.00±0.90),P<0.05].After treatment,the Scr and BUN of the observation group were(203.02±76.42)Pm-moI/L and(39.03±4.15)mmol/L respectively,both significantly lower than those of the control group[(330.02±80.78)and(46.60±5.05)mmol/L respectively,both P<0.05].There was no significant difference in the rate of adverse reactions between the 2 groups(P>0.05).Conclusion The prolongation of meropenem infusion time in the treatment of septic shock complicated with acute renal insufficiency has better clinical effects and is worthy of clinical use.

关 键 词：美罗培南 输液时间 脓毒症休克 急性肾功能不全 临床效果 

分 类 号：R459.7[医药卫生—急诊医学]