【摘要】：目的分析阿莫西林-雙氯西林聯(lián)合治療蜂窩組織炎伴高熱患者的臨床療效,為蜂窩組織炎患者臨床治療方案選擇提供參考。方法對醫(yī)院收治的22例蜂窩組織炎伴高熱患者采用阿莫西林-雙氯西林聯(lián)合治療,同時對患者病變部位取樣進行病原學(xué)分析,分析患者阿莫西林-雙氯西林聯(lián)合治療前后臨床癥狀改善情況、炎癥細(xì)胞因子(IL-6、IL-8、IL-10、超敏C-反應(yīng)蛋白)的改善情況,根據(jù)患者臨床治療的療效及病原學(xué)-藥敏分析結(jié)果調(diào)整敏感抗菌藥物治療,統(tǒng)計患者調(diào)整抗菌藥物治療情況,分析阿莫西林-雙氯西林聯(lián)合治療蜂窩組織炎伴高熱患者的臨床價值。結(jié)果 22例患者臨床癥狀為典型的蜂窩組織炎癥狀;22例患者患部擦拭取樣或膿液進行病原菌培養(yǎng),共分離出25株病原菌,其中革蘭陽性菌17株(均為金黃色葡萄球菌),革蘭陰性菌6株(溶血性鏈球菌5株,硝化菌1株),真菌2株;22例患者經(jīng)阿莫西林-雙氯西林聯(lián)合治療后,20例患者的臨床癥狀明顯改善,2例患者改用敏感抗菌藥物后臨床癥狀改善;患者治療后炎癥細(xì)胞因子(IL-6、IL-8、IL-10、超敏C-反應(yīng)蛋白)均較治療前明顯降低(P0.05),IL-10較治療前明顯升高(P0.05),2例患者治療3d后臨床癥狀無明顯改善,調(diào)整敏感抗菌藥物治療后,獲得較好療效。結(jié)論蜂窩組織炎伴高熱患者臨床較為少見,阿莫西林聯(lián)合雙氯西林對其進行經(jīng)驗性治療,可有效涵蓋病原菌譜,療效較好,使患者得到及時治療,具有較高的臨床價值。
[Abstract]:Objective to analyze the clinical effect of amoxicillin combined with dicloxicillin in the treatment of cellulitis with high fever, and to provide reference for clinical treatment of cellulitis. Methods 22 patients with cellulitis and high fever were treated with amoxicillin and dicloxicillin. To analyze the improvement of clinical symptoms and inflammatory cytokines (IL-6,IL-8,IL-10, hypersensitive C-reactive protein) before and after combined treatment with amoxicillin and dicloxicillin. According to the curative effect of clinical treatment of patients and the results of etiology-drug sensitivity analysis, we adjusted the treatment of sensitive antimicrobial agents and counted the situation of patients adjusting the treatment of antimicrobial agents. To analyze the clinical value of amoxicillin-dicloxicillin in the treatment of cellulitis with high fever. Results the clinical symptoms of 22 patients were typical cellulitis. A total of 25 strains of pathogenic bacteria were isolated, including 17 Gram-positive bacteria (all Staphylococcus aureus), 6 Gram-negative bacteria (hemolytic streptococcus 5, 1 nitrifying bacterium). 2 strains of fungi; After combined treatment with amoxicillin and dicloxicillin, the clinical symptoms of 20 patients were significantly improved, and the clinical symptoms of 2 patients were improved after the use of sensitive antimicrobial agents. After treatment, the inflammatory cytokines (IL-6,IL-8,IL-10, hypersensitive C- reactive protein) were significantly lower than those before treatment (P0.05), IL-10 was significantly higher than that before treatment (P0.05). After 3 days of treatment, the clinical symptoms of 2 patients were not obviously improved, and good results were obtained after adjusting sensitive antimicrobial agents. Conclusion Cellular histitis with high fever is rare in clinic. The empirical treatment of amoxicillin combined with dicloxicillin can effectively cover the spectrum of pathogenic bacteria and has a good curative effect. It makes the patients get timely treatment and has higher clinical value.
【作者單位】： 瑞安市人民醫(yī)院臨床藥學(xué)室;
【基金】：浙江省社發(fā)基金資助項目(2015zj00034)
【分類號】：R632.4
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本文編號：2421644