本文選題：亞胺培南 + 卒中　； 參考：《重慶醫(yī)學(xué)》2017年26期

【摘要】：目的評價亞胺培南對卒中相關(guān)性肺炎(SAP)的臨床療效。方法選擇2014年1月至2016年1月在西南醫(yī)科大學(xué)附屬醫(yī)院神經(jīng)內(nèi)科重癥監(jiān)護(hù)室(NICU)住院的SAP患者72例。在給予患者卒中相關(guān)治療及對癥支持治療的基礎(chǔ)上給予亞胺培南1.0g+0.9%生理鹽水100mL,每8小時注射1次,觀察治療過程中患者病情變化,比較治療2周前后實驗室檢查結(jié)果、胸部CT變化,并進(jìn)行危險因素相關(guān)性分析。結(jié)果治療期間死亡病例12例,存活60例。給予亞胺培南治療后2周體溫逐漸降至正常,治療后美國國立衛(wèi)生研究院卒中量表(NIHSS)評分、白細(xì)胞計數(shù)(WBC)、中性粒細(xì)胞數(shù)、C反應(yīng)蛋白均較治療前降低,血氣分析顯示氧分壓氧合指數(shù)均較治療前升高,胸部CT顯示炎性滲出病灶及滲出胸水較治療前吸收好轉(zhuǎn),72例患者痊愈55例,顯效5例,無效12例,總效率83.33%。危險因素相關(guān)性分析提示吞咽功能障礙、意識障礙、慢性阻塞性肺疾病急性發(fā)作病史均與療效呈負(fù)關(guān)聯(lián)。結(jié)論亞胺培南治療SAP效果滿意。
[Abstract]:Objective to evaluate the clinical effect of imipenem on stroke-associated pneumonia (SAP). Methods 72 patients with SAP were selected from January 2014 to January 2016 in the Neurology intensive Care Unit of the affiliated Hospital of Southwest Medical University. On the basis of stroke related treatment and symptomatic support therapy, imipenem 1.0 g 0.9% saline 100mL was injected once every 8 hours. The changes of patients' condition were observed and the results of laboratory examination before and after 2 weeks of treatment were compared. Chest CT changes and risk factors were analyzed. Results there were 12 cases of death and 60 cases of survival during treatment. After treatment with imipenem, the body temperature gradually decreased to normal. After treatment, the National Institutes of Health Stroke scale (NIHSS) score, white blood cell count (WBCU), neutrophil count (neutrophil count) and C-reactive protein (CRP) were all decreased compared with those before treatment. Blood gas analysis showed that oxygen partial pressure oxygenation index was higher than that before treatment. Chest CT showed that inflammatory exudation focus and effusion were better than those before treatment. 55 cases were cured, 5 cases were markedly effective, 12 cases were ineffective, and the total efficiency was 83.33%. Correlation analysis of risk factors showed that dysphagia, disturbance of consciousness, and history of acute attack of chronic obstructive pulmonary disease were all negatively correlated with curative effect. Conclusion imipenem is effective in the treatment of SAP.
【作者單位】： 西南醫(yī)科大學(xué)附屬醫(yī)院神經(jīng)內(nèi)科;四川省攀枝花市中心醫(yī)院神經(jīng)內(nèi)科;
【分類號】：R563.1;R743.3
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本文編號：1792579