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目的:观察阿米卡星不同给药方式治疗铜绿假单胞菌致呼吸机相关性肺炎(VAP)的临床疗效及安全性。方法:选择铜绿假单胞菌致VAP 112例,随机分为观察组和对照组各56例。在静脉使用抗生素、纤维支气管镜灌洗吸痰、营养支持、保持水电解质平衡等治疗的基础上,观察组采用0.45%无菌盐水250ml加阿米卡星0.2g 24h持续气管内滴入治疗;对照组采用0.45%无菌盐水250ml加阿米卡星0.2g雾化吸入治疗,每天1次。均7天为1个疗程。比较两组临床疗效和不良反应发生情况。结果:观察组显效率85.7%,总有效率96.4%,分别显著高于对照组的71.4%(P<0.05)和78.6%(P<0.05)。观察组不良反应发生率12.5%,对照组为67.8%;两组比较,差异非常显著(P<0.01)。结论:0.45%无菌盐水250ml加阿米卡星0.2g持续性气管内滴入法治疗铜绿假单胞菌致VAP的临床疗效,优于0.45%无菌盐水250ml加阿米卡星0.2g雾化吸入法,且较安全。
Objective: To observe the clinical efficacy and safety of amikacin in the treatment of ventilator-associated pneumonia (VAP) caused by Pseudomonas aeruginosa. Methods: 112 cases of VAP caused by Pseudomonas aeruginosa were randomly divided into observation group and control group with 56 cases each. In the intravenous antibiotics, bronchoscopy lavage suction, nutritional support, to maintain the balance of water and electrolyte treatment based on the observation group using 0.45% sterile saline 250ml plus amikacin 0.2g 24h continuous endotracheal infusion therapy; The control group with 0.45% sterile saline 250ml plus amikacin 0.2g inhalation therapy, 1 day. All 7 days for a course of treatment. The clinical efficacy and adverse reactions of the two groups were compared. Results: The effective rate of observation group was 85.7%, the total effective rate was 96.4%, which was significantly higher than 71.4% (P <0.05) and 78.6% (P <0.05) of the control group respectively. The incidence of adverse reactions in the observation group was 12.5% and that in the control group was 67.8%. The differences between the two groups were significant (P <0.01). Conclusion: 0.45% sterile saline 250ml plus amikacin 0.2g sustained tracheal instillation of Pseudomonas aeruginosa-induced VAP clinical curative effect, better than 0.45% sterile saline 250ml plus amikacin 0.2g fog Inhalation method, and more secure.