摘要
目的对注射用硫酸多黏菌素B的临床使用情况进行研究分析,为规范其临床使用、完善管控措施提供参考。方法对本院2018年1月1日-2019年8月31日期间使用注射用硫酸多黏菌素B的住院患者信息进行汇总,对患者人群特征、用药指征、用法用量、用药疗程、联合用药与病原学检查结果、临床治疗结局及不良反应等进行分析。结果共收集使用注射用硫酸多黏菌素B的住院患者63例,其中男性患者40例(64.06%),女性患者23例(35.93%),平均年龄(61.12±15.25)岁,平均住院天数(66.54±56.98)d。主要分布在呼吸科重症监护室、重症医学科和血液科等15个科室。感染类别前3位为肺部感染(49例,51.58%)、血流感染(23例,24.21%)和腹腔感染(16例,16.84%)等,63例患者均有病原学检查,送检率为100%。患者最终治疗痊愈0例,显效5例,好转11例,无效16例,死亡23例,因用药时间≤48 h而无法评判的有8例。发生急性肾损伤(AKI)的患者共有17例(26.98%),根据AKI分期,AKI 1期10例,AKI 2期4例,AKI 3期行连续性肾脏替代治疗(CRRT)的患者有3例。结论本院使用注射用硫酸多黏菌素B的患者均有明确指征;注射用硫酸多黏菌素B的肾脏毒性不容小觑,临床使用中应予以关注。
Objective To evaluate the clinical application of polymyxin B sulphas for injection,and to provide reference for standardizing its clinical use and improving monitor measures.Methods We collected patients data who were treated with polymyxin B injection in our hospital from January 1,2018 to August 31,2019.The patients characteristics medications,usage and dosage,course of treatment,treatment combination and etiology results,treatment results,and adverse reactions were analyzed.Results Totally 63 patients included:40 males(64.06%)and 23 females(35.93%).The average age was(61.12±15.25)years and the average hospital stay were(66.54±56.98)days.The 63 patients were from 15 departments of the hospital,such as the Respiratory Intensive Care Unit,the Department of Critical Care Medicine and the Hematology Department.Patients were treated by medication mainly against pulmonary infection(49,51.58%),bloodstream infection(23,24.21%)and abdominal infection(16,16.84%).All 63 patients had etiological examinations.After the final treatment,none was cured,5 were effective,11 were improved,16 were ineffective,23 dead and the rest 8 patients could not be judged due to medication time less than or equal to 48 hours.Seventeen patients(26.98%)developed acute renal injury(AKI):10 in AKI stage 1,4 in AKI stage 2,and 3 with continuous renal replacement therapy in AKI stage 3.Conclusion The patients who use polymyxin B injection in our hospital all have clear indicators.The nephrotoxicity of polymyxin B injection should not be underestimated in clinical use.
作者
王静
王佳微
王虎
吴艳
卞晓岚
方洁
WANG Jing;WANG Jia-wei;WANG Hu;WU Yan;BIAN Xiao-lan;FANG Jie(Department of Pharmacy,Ruijin Hospital Affiliated to School of Medicine,Shanghai Jiao Tong University,Shanghai 200025;School of Pharmacy,Wenzhou Medical University,Wenzhou Zhejiang 325035;School of Pharmacy,Shanghai Medical College,Shanghai 200025;Department of Pharmacy,Kunshan Hospital of Traditional Chinese and Western Medicine,Kunshan Jiangsu 215300)
出处
《中南药学》
CAS
2020年第6期1068-1071,共4页
Central South Pharmacy
基金
上海市卫生健康委员会卫生行业临床研究专项面上项目(No.201940197)。
作者简介
王静,女,主管药师,主要从事医院药学工作,E-mail:wj40608@rjh.com.cn;通信作者:方洁,女,硕士,主管药师,主要从事抗感染临床药学工作,E-mail:13916730218@139.com。
