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目的 探讨美罗培南治疗脓毒症休克的临床疗效。方法 回顾性分析2013年12月-2016年12月安康市中心医院收治的脓毒性休克患者120例,根据治疗方法的不同分为两组,每组60例。对照组患者给予液体复苏、升血压、抗炎等对症治疗,及时进行血液滤过治疗,同时接受其他广谱抗生素抗感染治疗。观察组在液体复苏、升血压、抗炎、血液净化等治疗基础上泵入美罗培南,将2 g注射用美罗培南溶于50 mL生理盐水中,使用微量注射泵持续泵入,持续8 h泵入完成,每日2次。评价两组患者治疗的临床疗效,并且采用感染相关的器官衰竭评分系统(SOFA)标准评价两组患者治疗后的器官衰竭程度,分别检测并比较两组患者治疗前后免疫炎症相关因子的水平。结果 观察组患者的治疗总有效率为88.33%,显著高于对照组的73.33%,差异有统计学意义(P<0.05)。经治疗,两组患者的血清降钙素原(PCT)、C反应蛋白(CRP)及SOFA评分等较治疗前显著降低,组内差异有统计学意义(P<0.05);且观察组上述指标显著低于对照组,组间差异有统计学意义(P<0.05)经治疗,观察组抗菌疗效的细菌总清除率为86.67%,显著高于对照组的71.67%,差异有统计学意义(P<0.05)。结论 美罗培南治疗脓毒症休克抗菌效应及临床疗效显著,值得临床推广应用。
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[Abstract]
Objective:To explore the curative effect of meropenem for septic shock. Methods 120 patients with septic shock were enrolled in our hospital from December 2013 to December 2016, of which all patients conducted conventional treatment and divided into two groups randomly, and control group (n=60) accepted another broad-spectrum antibiotics based conventional treatment, and study group (n=60) adopted meropenem treatment. The clinical curative effect were evaluated and analyzed, and the organ failure degree of two groups were evaluated via sepsis-related organ failure assessment (SOFA) gauge in post-treatment. The inflammatory factors of all patients were detected and analyzed respectively before and after treatment. Results The total effective rate of study group was higher significantly than that control group (P < 0.05). After treatment, the serum procalcitonin (PCT), C-response protein (CRP) and SOFA score decreased significantly (P < 0.05), and which indexes of study group were lower significantly than those patients in control group (P < 0.05). The total bacterial clearance of study group was higher than that control group, and which difference between two groups was significance (P < 0.05). Conclusions The antibacterial effect and clinical efficacy of meropenem were remarkable, and which deserved popularization in clinic.
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