ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2018, Vol. 10 ›› Issue (4): 349-351.doi: 10.3969/j.issn.1674-3865.2018.04.023

• 临床研究 • 上一篇    下一篇

88例小儿多重耐药菌临床特点、治疗策略及转归分析

田茂强，龙丽华，任洋，代建荣   

  1. 554300 贵州 铜仁，铜仁市人民医院儿科（田茂强），普儿科（龙丽华，任洋，代建荣）
  • 出版日期:2018-08-25 发布日期:2018-12-03
  • 通讯作者: 田茂强，E-mail：276782476@qq.com
  • 作者简介:田茂强（1967-），男，主任医师。研究方向：小儿神经内科疾病的诊治

Clinical features of 88 children with multiple resistant bacteria, its treatment strategy and the analysis of prognosis

TIAN Maoqiang, LONG Lihua，REN Yang，DAI Jianrong   

  1. Tongren People's Hospital, Tongren 554300，China
  • Online:2018-08-25 Published:2018-12-03

PDF (PC)

96

摘要：
目的
探讨多重耐药菌住院患儿的临床特点，总结有效的治疗策略，为临床合理使用抗生素提供参考依据。
方法
2014年1月至2016年12月铜仁市人民医院儿科收治住院的患儿中监测有多重耐药菌感染者88例，综合分析患儿临床特点（包括全身炎症反应、血常规、C反应蛋白、降钙素等感染指标），监测后的治疗策略及其转归。综合分析是否调整经验用药为敏感抗生素，分为调节敏感抗生素组17例和未调节敏感抗生素组71例。
结果
调节敏感抗生素组白细胞计数、中性粒细胞比例、降钙素均有增高，C反应蛋白调节敏感抗生素降低，但白细胞计数两组比较差异无统计学意义（P>0.05）；中性粒细胞比例、C反应蛋白、降钙素两组比较差异有统计学意义（P<0.05）。全身炎症反应表现两组比较，调节敏感抗生素组较明显，未调节敏感抗生素组不明显。未调节敏感抗生素组治愈率为95.8%（68/71），高于调节敏感抗生素组76.5%（13/17），平均住院时间为（7.44±1.13）d，少于调节敏感抗生素组（10.22±2.53）d，差异有统计学意义（P<0.05）。
结论
在临床工作中应科学的分析临床特点及监测结果，制定相应的治疗策略，合理科学的使用抗生素，保障患儿治疗的有效性及安全性。

关键词: 多重耐药菌, 临床特点, 治疗策略, 转归, 儿童

Abstract:
Objective:
To explore the clinical features of hospitalized children with multiple resistant bacteria and summarize effective treatment strategies in order to provide reference for reasonable use of antibiotics.
Methods:
In the children hospitalized for treatment in Tongren People's Hospital from Jan. 2014 to Dec. 2016,there were 88 children with multidrugresistant bacteria infection. The clinical features of these children were comprehensively analyzed(including systematic inflammatory response, routine blood test, C-reactive protein and calcitonin). The treatment strategies and prognosis were also analyzed to decide whether the drugs used according to experience were adjusted to sensitive antibiotics. The children were divided into two groups: the adjusted antibiotic group(group A,17 cases) and the nonadjusted antibiotic group(group B,71 cases).
Results:
The white blood cell count, neutrophil proportion, and calcitonin increased in group A, while C-reactive protein decreased, but there was no statistical difference in WBC count between group A and group B(P>0.05);there was statistical difference in neutrophil proportion, C-reactive protein and calcitonin between the two groups(P<0.05). The systematic inflammatory response was obvious in group A, but not obvious in group B. The cure rate of group B was 95.8%(68/71), which was higher than that of group A(76.5%,13/17). The mean length of hospital stay was (7.44±1.13)d in group B, shorter than that of group A［(10.22±2.53)d,P<0.05］.
Conclusion:In clinical work, it is necessary to scientifically analyze the clinical features and monitoring results, make correspondent treatment strategies use antibiotics reasonably in order to guarantee the effect and safety of the treatment.

Key words: Multiple resistant bacteria, Clinical features, Treatment strategy, Prognosis, Child