贵州医科大学学报

2018, v.43;No.211(04) 454-457

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抗生素降阶梯治疗策略在新生儿感染性肺炎中的应用
Application of Antibiotic De-escalation Therapy in Neonatal Infectious Pneumonia

伏丽琼;朱斌;赵芳芳;
FU Liqiong;ZHU Bin;ZHAO Fangfang;The First People's Hospital of Guangyuan;

摘要(Abstract):

目的:探讨抗生素降阶梯治疗策略在新生儿感染性肺炎中的效果。方法:160例新生儿感染性肺炎患儿根据抗生素治疗策略分为降阶梯组(90例)和对照组(70例),对照组患儿给予常规抗生素方案治疗,降阶梯组患儿在常规治疗的基础上给予抗生素降阶梯策略治疗;治疗7 d后评估两组患儿的临床疗效、治疗恢复进度,并检测两组患儿的血清降钙素原(PCT)、超敏C反应蛋白(CRP)及白细胞(WBC)水平。结果:降阶梯组临床总有效率为87.78%,显著高于对照组74.29%,差异有统计学意义(P<0.05);与对照组相比,降阶梯组患儿的感染控制时间、呼吸机通气时间、ICU住院时间及抗生素使用时间均明显缩短,差异有统计学意义(P<0.05);两组患儿治疗前PCT、CRP、WBC比较,差异无统计学意义(P>0.05);治疗后,降阶梯组血清CRP、PCT水平及血液WBC计数明显低于对照组,差异有统计学意义(P<0.05)。结论:抗生素降阶梯策略治疗新生儿感染性肺炎疗效突出,可有效控制患儿病情、加快恢复进程及改善血清学感染指标。
Objective: To explore the effects of antibiotic de-escalation therapy in neonatal infectious pneumonia. Methods: 160 neonates with infective pneumonia were divided into two groups according to antibiotic treatment: de-escalation group( 90 cases) and control group( 70 cases). Children in the control group were treated with routine antibiotic regimen,and those in the de-escalation group were treated with antibiotic de-escalation therapy on the basis of routine treatment. After 7 days of treatment,the clinical efficacy and recovery progress of the two groups were evaluated,and the levels of procalcitonin,Hypersensitive C-reactive protein and white blood cell were measured. Results: The total clinical effective rate of the de-escalation group was 87. 78%,which was significantly higher than that of the control group( 74. 29%). The difference was statistically significant( P < 0. 05). Compared with the control group,the infection control time,ventilator time,ICU hospitalization time and antibiotic use time in the de-escalation group were significantly shorter than those in the control group,and the difference was statistically significant( P < 0. 05). There was no significant difference in PCT,CRP and WBC between the two groups before treatment( P > 0. 05). After treatment,the level of serum CRP and PCT and the blood WBC count in the de-escalation group were significantly lower than those in the control group,and the difference was statistically significant( P < 0. 05). Conclusions: The antibiotic de-escalation therapy is effective in the treatment of infective pneumonia in newborns. It can effectively control the patient's condition,accelerate the process of recovery and improve the index of serological infection.

关键词(KeyWords): 抗生素;新生儿;感染性肺炎;降阶梯策略
antibiotics;neonate;infectious pneumonia;de-escalation strategy

Abstract:

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基金项目(Foundation): 四川省卫生和计划生育委员会科研课题(1401722)

作者(Author): 伏丽琼;朱斌;赵芳芳;
FU Liqiong;ZHU Bin;ZHAO Fangfang;The First People's Hospital of Guangyuan;

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DOI: 10.19367/j.cnki.1000-2707.2018.04.017

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