本文選題：非發(fā)酵菌 + 肺部感染��； 參考：《新疆醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：非發(fā)酵菌是需氧不發(fā)酵糖類革蘭陰性桿菌,廣泛分布于水、土壤、醫(yī)院環(huán)境和人體的皮膚表面,屬于條件致病菌,并且是住院患者常見的病原體,尤其是免疫缺陷和重癥監(jiān)護(hù)病房(intensive care unit, ICU)的危重患者。銅綠假單胞菌(pseudomonas aeruginosa PA)和鮑曼不動(dòng)桿菌(Acinetobacter baumannii, AB)是常見的非發(fā)酵菌,也是臨床常見的致病菌。本研究初步探討痰熱清在ICU兩種常見非發(fā)酵菌肺部感染中的作用,為臨床更加有效地治療非發(fā)酵菌提供理論依據(jù)。方法：對(duì)我院2012年1月-2013年3月重癥醫(yī)學(xué)科痰培養(yǎng)提示為鮑曼不動(dòng)桿菌和銅綠假單胞菌131例患者,其中定植患者10例,肺部感染患者121例,符合兩種非發(fā)酵菌肺部感染的患者隨機(jī)分為對(duì)照組69例和觀察組52例,定植患者隨訪觀察,對(duì)照組按照常規(guī)治療法治療,抗菌素應(yīng)用根據(jù)病原微生物培養(yǎng)及藥敏結(jié)果確定,觀察組在常規(guī)治療的基礎(chǔ)上輔助痰熱清注射液治療；通過(guò)對(duì)比兩組患者的一般資料、APACHEⅡ評(píng)分的差值、SOFA評(píng)分的差值、ICU住院天數(shù)、28天內(nèi)抗菌素使用天數(shù)、機(jī)械通氣的天數(shù)及兩組28天、90天病死率等指標(biāo)。結(jié)果：通過(guò)兩組的對(duì)比,其兩組的一般資料無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；其中觀察組的APACHE Ⅱ評(píng)分、SOFA評(píng)分的差值明顯高于對(duì)照組,即觀察組APACHE Ⅱ評(píng)分、SOFA評(píng)分較對(duì)照組下降更明顯,且觀察組ICU住院天數(shù)、28天內(nèi)抗菌素使用天數(shù)、機(jī)械通氣的天數(shù)均明顯低于對(duì)照組(P0.05)；但兩組28天、90天病死率無(wú)明顯差異(P0.05)。結(jié)論：痰熱清注射液與抗菌素具有協(xié)同抗菌作用,對(duì)治療兩種常見非發(fā)酵菌肺部感染具有一定療效。
[Abstract]:Objective: Non-fermentative bacteria are aerobic non-fermentative glycosylgram-negative bacilli. They are widely distributed in water, soil, hospital environment and skin surface of human body. They belong to conditional pathogens and are common pathogens in inpatients. Especially critical patients with immune deficiency and intensive care unit (intensive care unit, ICU). Pseudomonas aeruginosa (pseudomonas aeruginosa PA) and Acinetobacter baumannii (Acinetobacter baumannii, AB) are common non-fermentative bacteria and common clinical pathogens. The purpose of this study was to explore the role of Tanreqing in the lung infection of two common non-fermentative bacteria in ICU, and to provide a theoretical basis for the clinical treatment of non-fermentative bacteria. Methods: from January 2012 to March 2013, 131 patients with Acinetobacter baumannii and Pseudomonas aeruginosa were identified as Acinetobacter baumannii and Pseudomonas aeruginosa, including 10 colonized patients and 121 patients with pulmonary infection. Patients with pulmonary infection of two kinds of non-fermentative bacteria were randomly divided into the control group (69 cases) and the observation group (52 cases). The patients in the control group were followed up and observed. The patients in the control group were treated according to the routine therapy, and the application of antibiotics was determined according to the results of pathogenic microorganism culture and drug sensitivity. The observation group was treated with Tanreqing injection on the basis of routine treatment, the difference of Apache 鈪，

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