摘要
目的:观察头孢米诺钠与头孢唑肟钠序贯治疗重症加强护理病房(ICU)重症颅脑损伤患者肺部感染的临床疗效及安全性。方法:选择108例ICU重症颅脑损伤并发肺部感染患者,随机均分为两组。所有患者首先均给予头孢米诺钠2 g,加入0.9%氯化钠注射液40 ml中静脉滴注,bid,治疗3 d,如出现好转,对照组患者继续给予头孢米诺钠静脉滴注,剂量减为1 g,bid;观察组患者改用头孢唑肟钠2 g,加入0.9%氯化钠注射液250 ml中静脉滴注,q8 h或q12 h,严重感染者剂量可增至3～4 g,两组患者均继续治疗4 d。监测两组患者治疗前后的血尿常规、丙氨酸氨基转移酶、总胆红素、尿素氮、血肌酐及X线胸片,观察两组患者临床疗效、细菌学疗效及不良反应情况。结果:观察组患者总有效率较对照组患者显著升高,差异有统计学意义(P<0.05);观察组患者细菌转阴率较对照组患者显著升高,差异有统计学意义(P<0.05);两组患者除个别出现轻度皮肤过敏反应和给药后丙氨酸氨基转移酶进一步升高外,未见其他明显不良反应发生。结论:头孢米诺钠与头孢唑肟钠序贯治疗ICU重症颅脑损伤患者肺部感染具有显著的临床疗效,可减少头孢米诺钠耐药性的产生,提高细菌转阴率,且安全性较好。
OBJECTIVE ： To observe clinical efficacy and safety of sequential therapy of cefminox and ceftizoxime in the treat- ment of pulmonary infection in ICU patients with severe traumatic brain injury. METHODS： 108 ICU patients with severe traumat- ic brain injury complicating with pulmonary infection admitted to a hospital were randomly divided into 2 groups. Both groups were given intravenous injection of cefminox sodium 2 g after dissolved in 0.9% Sodium chloride injection 40 ml, twice a day for con- secutive 3 days. If improved to some extent, control group continued to be given intravenous injection of eefminox sodium 1 g, twice a day; observation group was given intravenous injection of ceftizoxime sodium 2 g instead, added into 0.9% sodium chlo- ride injection 250 ml, every 8 or 12 h. For the patients with severe pulmonary infection, the drug was given 3-4 g for consecutive 4 days. Blood and urine routine, alanine aminotransferase, total bilirubin, urine nitrogen, creatinine and chest x-ray film of both groups were monitored before and after treatment. Clinical efficacy, bacteriological efficacy and adverse drug reaction of two groups were observed. RESULTS： Compared with control group, the total effective rate of observation group was improved signifi- cantly; there was statistical significance （P〈0.05）. The negative conversion rate of sputum bacteria in observation group was im- proved significantly; there was statistical significance （P〈0.05）. Only a few patients suffered from mild skin allergy and the in- crease of alanine aminotransferase. No other obvious ADR was observed during treatment. CONCLUSIONS： Sequential therapy of cefminox sodium and ceftizoxime sodium in the treatment of pulmonary infection in ICU patients with severe traumatic brain injury can improve clinical efficacy, reduce drug resistance of cefminox sodium and improve negative conversion rate of sputum bacteria with sound safety.
出处
《中国药房》
CAS
CSCD
2013年第40期3776-3778,共3页
China Pharmacy
作者简介
主治医师。研究方向：危重病抢救。电话：0579—85359136。E．mail：jlhljtr@163．com
