首剂抗生素用药时间对严重脓毒症患儿临床疗效的影响研究  

Effect of medication time of first-dose antibiotics on clinical efficacy of children with severe sepsis

作　　者：卿璐 刘忠强[1] 罗黎力[1] 乔丽娜[1] QING Lu;LIU Zhongqiang;LUO Lili;QIAO Lina(Department of Pediatric Critical Medicine,West China Second University Hospital of Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西第二医院儿童重症医学科,四川成都610041

出　　处：《现代医药卫生》2021年第19期3237-3239,3243,共4页Journal of Modern Medicine & Health

基　　金：国家自然科学基金项目(81701499)。

摘　　要：目的探讨首剂抗生素应用时间对严重脓毒症患儿临床疗效的影响。方法选取2015年7月至2016年6月该院儿科重症监护病房住院治疗的106例严重脓毒症患儿,按首剂抗生素使用时间分为小于1 h组(22例)、≥1 h组(84例)和小于3 h组(86例)、≥3 h组(20例)。比较各组住院时间及体温、白细胞计数、C反应蛋白(CRP)、降钙素原(PCT)、乳酸恢复正常时间。结果<1 h组患儿治愈率低于大于或等于1 h组,差异无统计学意义(P>0.05)。<3 h组患儿治愈率高于大于或等于3 h组,差异有统计学意义(P<0.05)。随着首剂抗生素使用时间的延迟,患儿治愈率逐渐降低。各组患儿均无重大药物不良反应发生。<1 h、≥1 h组患儿CRP恢复正常时间比较,差异有统计学意义(P<0.05),而住院时间及体温、PCT、乳酸、白细胞计数恢复正常时间比较,差异均无统计学意义(P>0.05)。<3 h、≥3 h组患儿住院时间及体温、PCT恢复正常时间比较,差异均有统计学意义(P<0.05),而乳酸、白细胞计数、CRP恢复正常时间比较,差异均无统计学意义(P>0.05)。结论对于严重脓毒症患儿,3 h内使用抗生素进行治疗能取得更好的疗效,在炎症指标恢复、缩短住院时间方面更优。Objective To explore the effect of the medication time of the first-dose antibiotics on the clinical efficacy of children with severe sepsis.Methods 106 children with severe sepsis hospitalized in the pediatric intensive care unit of the hospital from July 2015 to June 2016 were selected and divided into<1 h group(22 cases),≥1 h group(84 cases),<3 h group(86 cases)and≥3 h group(20 cases)by the medication time of the first-dose antibiotics.The hospitalization time and the recovery time of body temperature,leukocyte count,C-reactive protein(CRP),procalcitonin(PCT)and lactate in each group were compared.Results The cure rate of children in the<1 h group was lower than that in the≥1 h group,and the difference was not statistically significant(P>0.05).The cure rate of children in the<3 h group was higher than that in the≥3 h group,and the difference was statistically significant(P<0.05).With the delay of the medication time of the first-dose antibiotics,the cure rate of children decreased gradually.There were no significant adverse drug reactions in each group.There was significant difference in the recovery time of CRP of children between the<1 h and≥1 h groups(P<0.05),but there were no significant differences in the hospitalization time and the recovery time of body temperature,PCT,lactic acid and leukocyte count(P>0.05).There were significant differences in the hospitalization time and the recovery time of body temperature,PCT of children between the<3 h and≥3 h groups(P<0.05),but there were no significant differences in the hospitalization time and the recovery time of lactic acid,leukocyte count and CRP(P>0.05).Conclusion For children with severe sepsis,using antibiotics within 3 h can achieve better curative effect,and it is better in the recovery of inflammatory indexes and shortening hospital stay.

关 键 词：儿童 严重脓毒症 抗生素 时效性 

分 类 号：R72[医药卫生—儿科]