發(fā)布時間：2018-12-16 00:03

【摘要】：目的分析萬古霉素不同給藥次數(shù)與重癥監(jiān)護(hù)病房(PICU)患兒血藥濃度的關(guān)系,不同谷濃度與療效的關(guān)系,以及藥物不良反應(yīng)。方法回顧2013年1月—2016年6月入住PICU并使用萬古霉素的72例患兒的臨床資料,其中58例萬古霉素劑量為40 mg/(kg·d),14例60 mg/(kg·d);劑量40 mg/(kg·d)的患兒中q12h給藥19例,q8h給藥22例,q6h給藥17例;萬古霉素給藥至少4個劑量后,在給藥前30 min內(nèi)采集血標(biāo)本檢測谷濃度;給藥結(jié)束后30~60 min內(nèi)采集血標(biāo)本檢測峰濃度;以高效液相色譜(HPLC)法快速測定血漿萬古霉素濃度。結(jié)果萬古霉素以40 mg/(kg·d)進(jìn)行治療時,q12h、q 8 h和q 6 h三組之間萬古霉素谷濃度與峰濃度的差異均無統(tǒng)計學(xué)意義(P0.05)。萬古霉素谷濃度≤5μg/m L和5μg/m L組之間顯效及有效率差異無統(tǒng)計學(xué)意義(81.8%對84.0%,P0.05)。與萬古霉素40 mg/(kg·d)組(q 8 h)比較,60 mg/(kg·d)組谷濃度與峰濃度均明顯升高,差異有統(tǒng)計學(xué)意義(P0.05)。結(jié)論使用常規(guī)劑量的萬古霉素谷濃度難以達(dá)到10μg/m L;為達(dá)到有效治療濃度,降低不良反應(yīng),可增加萬古霉素劑量,增加給藥次數(shù)。
[Abstract]:Objective to analyze the relationship between different times of vancomycin administration and serum concentration of vancomycin in (PICU) children, the relationship between different concentrations of vancomycin and curative effect, and adverse drug reactions. Methods the clinical data of 72 children admitted to PICU from January 2013 to June 2016 with vancomycin were retrospectively reviewed, of which 58 cases were treated with vancomycin (40 mg/ (kg d),) and 14 cases (60 mg/ (kg d);) with vancomycin. In the 40 mg/ (kg d) group, 19 cases were given q12h, 22 cases Q8h, 17 cases Q6h, and at least 4 doses of vancomycin, the blood samples were collected 30 min before the administration of vancomycin to detect the grain concentration. The peak concentration of plasma vancomycin was determined by high performance liquid chromatography (HPLC), and the plasma vancomycin concentration was determined by high performance liquid chromatography (HPLC). Results when vancomycin was treated for 40 mg/ (kg d), there was no significant difference in the concentration and peak concentration of vancomycin between the three groups (P0.05). There was no significant difference in efficacy and effective rate between groups of vancomycin concentration 鈮，

本文編號：2381510