亚胺培南西司他丁钠治疗急诊重症感染的临床效果  

Clinical effect of imipenem cilastatin sodium in the treatment of severe infection in emergency department

作　　者：高培亮 甄国栋 徐笑群 GAO Peiliang;ZHEN Guodong;XU Xiaoqun(Department of Emergency,Linyi Central Hospital,Shandong Province,Linyi 276400,China;不详)

机构地区：[1]山东省临沂市中心医院急诊科,276400 [2]山东省临沂市中心医院药剂科,276400

出　　处：《临床合理用药》2025年第7期22-25,共4页Chinese Journal of Clinical Rational Drug Use

基　　金：临沂市重点研发计划(医学类)(2023YX0112)。

摘　　要：目的观察亚胺培南西司他丁钠治疗急诊重症感染的临床效果。方法选取2022年8月—2024年1月临沂市中心医院急诊科收治的重症感染患者84例,以多阶段抽样法分为试验组和对照组,各42例。试验组予亚胺培南西司他丁钠治疗,对照组予美罗培南治疗,2组均连续治疗14 d。比较2组临床疗效、康复相关指标,治疗前后血清炎性因子[白介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)及肿瘤坏死因子-α(TNF-α)],病原菌清除情况及不良反应。结果试验组总有效率为97.62%,高于对照组的83.33%(χ^(2)=4.973,P=0.025);试验组退热时间、白细胞计数恢复正常时间及ICU住院时间均较对照组短(P<0.01);治疗14 d后,2组IL-6、CRP、PCT及TNF-α水平低于治疗前,且试验组低于对照组(P<0.01);试验组病原菌清除率为95.24%,高于对照组的80.95%(χ^(2)=4.086,P=0.043);试验组不良反应总发生率为7.14%,低于对照组的23.81%(χ^(2)=4.459,P=0.034)。结论急诊重症感染患者应用亚胺培南西司他丁钠治疗能提升临床疗效,有效降低血清炎性因子水平,促进白细胞恢复,缩短ICU住院时间,提高病原菌清除率,且不良反应较少。Objective To observe the clinical effect of imipenem cilastatin sodium in the treatment of severe infection in emergency department.Methods Eighty four patients with severe infection admitted to the emergency department of Linyi Central Hospital from August 2022 to January 2024 were selected and divided into the experimental group and the control group by multistage sampling method,42 cases in each group.The experimental group was treated with imipenem cilastatin sodium,and the control group was treated with meropenem.Both groups were treated for 14 days.The clinical efficacy,rehabilitation related indicators,serum inflammatory factors(IL-6,CRP,PCT,TNF-α)before and after treatment,pathogen clearance and adverse reactions were compared between the two groups.Results The total effective rate of the experimental group was 97.62%,which was higher than 83.33%of the control group(χ^(2)=4.973,P=0.025).The defervescence time,the recovery time of WBC count and the length of ICU stay in the experimental group were shorter than those in the control group(P<0.01).After 14 days of treatment,the levels of IL-6,CRP,PCT and TNF-αin the two groups were lower than those before treatment,and those in the experimental group were lower than those in the control group(P<0.01).The clearance rate of pathogenic bacteria in the experimental group was 95.24%,which was higher than 80.95%in the control group(χ^(2)=4.086,P=0.043).The total incidence of adverse reactions in the experimental group was 7.14%,which was lower than 23.81%in the control group(χ^(2)=4.459,P=0.034).Conclusion The application of imipenem cilastatin sodium in emergency patients with severe infection can improve the clinical efficacy,effectively reduce the level of serum inflammatory factors,promote the recovery of WBC,shorten the length of ICU stay,improve the clearance rate of pathogenic bacteria,and have fewer adverse reactions.

关 键 词：重症感染 急诊 亚胺培南西司他丁钠 炎性因子 不良反应 

分 类 号：R47[医药卫生—护理学]