抗生素降阶梯治疗慢性阻塞性肺疾病合并重症感染的可行性及安全性探讨.

目的 探讨采用抗生素降阶梯治疗慢性阻塞性肺疾病合并重症感染的临床效果.方法 随机选取2013年2月至2015年4月本院收治的92例慢性阻塞性肺疾病合并重症感染患者,按照入院顺序先后分为观察组和对照组.对照组患者行常规抗生素治疗,观察组患者接受抗生素降阶梯治疗方案.对两组患者的临床治疗效果进行回顾性分析.结果 观察组患者的咳嗽、肺部湿罗音、痰鸣音等临床症状的消失时间均明显短于对照组,住院时间明显少于对照组,差异有统计学意义(P＜ 0.05);观察组患者的总治疗有效率明显高于对照组,差异有统计学意义(91.11％ vs.53.33％,P＜0.05).结论 对慢性阻塞性肺疾病合并重症感染患者实施抗生素降阶梯治疗,能够有效对肺部感染进行控制,对于患者临床症状及预后的改善具有十分显著的作用,建议在临床上进一步推广.

Feasibility and safety of de-escalation antibiotic therapy for chronic obstructive pulmonary disease combined with serious infection

Objective To study the clinical curative effect of de-escalation antibiotic therapy in chronic obstructive pulmonary disease (COPD) combined with serious infection.Methods 92 patients with COPD combined with serious infection admitted in our hospital from February 2013 to April 2015 were randomly selected,and divided into observation group and control group according to the order of admission.Control group was treated with routine antibiotics;while observation group was treated with de-escalation antibiotic therapy.Clinical curative effect of two groups was analyzed retrospectively.Results Disappearance time of clinical symptoms such as cough,pulmonary moist rales,wheezy phlegm of observation group were significantly shorter than those of control group,the length of stay of observation group was significantly less than that of control group,with statistically significant differences (P＜0.05).The total effective rate of observation group was significantly higher than that of control group (91.11％ vs.53.33％),with statistically significant difference (P＜0.05).Conclusion The application of de-escalation antibiotic therapy in patients with COPD combined with serious infection can effectively control pulmonary infection,which has very significant effect on the improvement of clinical symptoms and prognosis of patients,worthy of further promotion in clinical practice.