刘伟娜

[摘要] 目的 觀察阿奇霉素联合头孢派酮钠/舒巴坦钠治疗老年肺炎的效果。 方法 选取我院2018年1～7月收治的80例老年肺炎患者，按照细菌培养后根据培养结果给予患者两种不同治疗方案并进行分组，分为对照组35例，观察组45例。对照组患者使用亚胺培南联合左氧氟沙星治疗，观察组患者使用阿奇霉素联合头孢派酮钠/舒巴坦钠治疗，对比观察两组患者治疗前后的血浆内D-二聚体、痰液、血液中促炎症因子水平和临床治疗效果。两组患者接受治疗介入后，将两组患者的不良反应发生率进行对比;经过治疗介入之后，对比两组患者的咳嗽消失时间、喘息消失时间、啰音消失时间、退烧时间、住院时间。 结果 观察组（86.67%）的总有效率明显高于对照组（71.43%），治疗后两组患者的D-二聚体及痰液、血液中促炎症因子水平均有下降趋势，观察组的下降趋势更为显著（P<0.05）。观察组患者（4.44%）的不良反应明显少于对照组（25.71%）（P<0.05）。观察组患者的各种症状减少时间和住院时间明显短于对照组（P<0.05）。 结论 阿奇霉素联合头孢派酮钠/舒巴坦钠治疗老年肺炎效果明显，值得推广。

[关键词] 阿奇霉素;头孢派酮钠;舒巴坦钠;老年肺炎; 治疗效果

[中图分类号] R563.1          [文献标识码] B          [文章编号] 1673-9701（2020）31-0103-04

[Abstract] Objective To observe and analyze the effect of azithromycin combined with cefoperazone sodium/sulbactam sodium in the treatment of senile pneumonia. Methods Eighty patients with senile pneumonia admitted to our hospital from January 2018 to July 2018 were given two different treatment plans and grouped according to the culture results after bacterial culture. They were divided into 35 cases in the control group and 45 cases in the observation group. Patients in the control group were treated with imipenem combined with levofloxacin， and patients in the observation group were treated with azithromycin combined with cefoperazone sodium/sulbactam sodium. The plasma D-dimer， sputum and blood pro-inflammatory factor levels， and clinical treatment effect of the two groups were compared before and after treatment. After the two groups of patients received therapeutic intervention， the probability of adverse reactions between the two groups was compared. The cough disappearance time， wheeze disappearance time， rale disappearance time， fever reduction time， and hospital stay between two groups were compared. Results The total effective rate of the observation group （86.67%） was significantly higher than that of the control group （71.43%）. After treatment， the levels of D-dimer， sputum and blood pro-inflammatory factors in the two groups had a downward trend. The downward trend of the observation group was more significant（P<0.05）. The adverse reactions of patients in the observation group （4.44%） were significantly less than those （25.71%） in the control group （P<0.05）. The reduction time of various symptoms and the length of stay in the observation group was shorter than that of the control group（P<0.05）. Conclusion Azithromycin combined with cefoperazone/ sulbactam sodium is effective in the treatment of elderly pneumonia and is worthy of promotion.

[Key words] Azithromycin; Cefoperazone Sodium; Sulbactam Sodium; Senile pneumonia; Observation; Treatment effect

与年轻人群体相比较，老年肺炎的发病率和死亡率呈上升趋势，其原因较多。随着人体老化，呼吸系统解剖和功能退化会致使全身和呼吸道的局部防御和免疫力下降，可能会使患者患上老年肺炎[1]。老年肺炎治疗难度大、漏诊率较高、预后能力差等，直接影响肺炎的治疗效果[2-3]。近年来，为了合理地使用治疗药物，配合老年患者机体免疫力差、耐药菌株多等缺陷，以及提高治疗效果，因此本研究选取我院2018年1～7月收治的80例老年肺炎患者，观察分析阿奇霉素联合头孢派酮钠/舒巴坦钠治疗老年肺炎的效果，现报道如下。……