应用抗生素治疗老年慢性肾功能不全并细菌感染60例疗效分析

目的探索应用抗生素治疗慢性肾功能不全失代偿期合并下呼吸道感染的老年患者的临床效果和对其肾功能的影响。方法选取我院自2008年5月～2011年10月我院治疗的60例肾功能不全合并肺部感染的老年患者纳入观察组,同期选取60肾功能正常的老年下呼吸道感染的患者纳入对照组。两组患者应用头孢哌酮进行治疗,观察两组患者的总体治疗效果差异以及观察组患者治疗前后的肾功能血肌酐、尿素氮、尿酸、肌酐清除率水平差异。结果观察组和对照组患者平均治疗时间分别为(10.15±3.23)天和(7.32±2.18)天,差异有统计学意义(P<0.05);两组患者的总体治疗效果差异不明显(P>0.05),但痊愈率差异有统计学意义(P<0.05);观察组治疗前后患者的血肌酐、尿素氮、内生肌酐清除率水平与治疗前比较差异有统计学意义(P<0.05)。结论肾功能不全的老年患者一旦发生下呼吸道感染,应用抗生素治疗的难度增大,治疗过程中应密切留意患者的肾功能情况,并合理控制药物用量,一旦出现肾功能衰竭应立即停药,必要时进行血液透析。

Clinical Effect of Antibiotics to Treat 60 Elderly Patients with Chronic Renal Insufficiency and Bacterial Infection

Objective Explore the clinical effect of antibiotics to treat 60 elderly patients with chronic renal insufficiency and bacterial infection, and influence to the renal function. Methods Choosing 60 elderly patients with chronic renal failure and 60 elderly patients with normal renal function, all patients were suffered from lower respiratory tract infection, who were treated by Ceftazidime in our hospital from May 2008 to October 2011. Observe the difference of clinical effect and renal function change before and after treatment. Results The average treatment time of observation group and control group were（10.15±3.23） d and （7.32±2.18） d （P〈0.05）; There were no statistical means of overall treatment effect（P〉0.05）, but difference of cure rate between two groups was significant（P〈0.05）; Besides, the difference of SCr, BUN, and CCr before and after treatment is significant：（P 〈0.05）. Conclusion Using Antibiotics to treat bacterial infection of elderly patient with chronic renal insufficiency is harder than treating with elderly patients normal renal function. More attention need to be paid to them, and once presents renal insufficiency, the drug should be immediately discontinued, treat them with hemodialysis when necessary.