【摘要】 目的 探討左氧氟沙星聯合阿奇霉素治療老年難治性呼吸道感染的療效及安全性。 方法 選擇2005年2月-2010年9月收治的高齡難治性呼吸道細菌感染患者68例，隨機分為治療組和對照組。治療組34例，給予左氧氟沙星聯合阿奇霉素；對照組34例，給予左氧氟沙星，兩組總療程皆為15 d。觀察兩組患者的臨床療效、細菌清除率和不良反應。 結果 治療組的總有效率為64.71%，對照組總有效率為32.35%，兩組差異有統計學意義（Plt;0.05） 。治療組細菌清除率為76.19%，對照組細菌清除率為36.36%，兩組差異有統計學意義（Plt;0.05） 。治療組和對照組的不良反應發生率分別為5.88%和8.82%，差異無統計學意義（Pgt;0.05）。結論 左氧氟沙星聯合阿奇霉素治療老年難治性呼吸道感染療效高， 能有效清除細菌， 不良反應較少， 值得臨床推廣應用。【Abstract】 Objective To evaluate the efficacy and safety of levofloxacin combined with azithromycin on refractory respiratory infections in elder patients. Methods A total of 68 elder patients with refractory respiratory infections in our hospital from February 2005 to September 2010 were randomly divided into two groups: treatment group (n=34) and control group (n=34). The patients in treatment group were treated with levofloxacin combined with azithromycin; while the patients in the control group were treated with levofloxacin alone. The total treatment periods of both groups were 15 days. The therapeutic efficacy, eradication rate of pathogens and the rate of aelverse reactions were observed. Results The therapeutic effect rate was 64.71% in the treatment group and 32.35% in the control group, and the difference between the two groups was statistically significant (Plt;0.05). The eradication rate of pathogens was 76.19% in the treatment group and 36.36% in the control group, and the difference was significant (Plt;0.05). The rate of the adverse reaction was 5.88% in the treatment group and 8.82% in the control group, and there were no significant differences between the two groups (Pgt;0.05). Conclusion Levofloxacin combined with Azithromycin is effective on refractory respiratory tract infection in elder patients, which can effectively remove the bacteria with few adverse reaction.
【摘要】 目的 探討老老年患者留置尿管內壁細菌生物被膜形成情況及其對導管相關感染(CRI)的影響。〖HTH〗方法〖HTSS〗 分析2007年2月—2009年10月住院的175例留置尿管患者,均為男性,年齡75~96歲,平均86歲。不同留置時間(7~15 d 53例、16~30 d 49例、31~45 d 44例、gt;45 d 29例)的尿管,于拔出尿管后運用超聲震蕩使尿管內表面生物被膜完全脫落,梯度稀釋后進行生物被膜活菌計數,細菌的培養分類及構成比分析；采用掃描電鏡觀察尿管內壁細菌生物被膜形成的情況；觀察尿管留置時間與生物被膜CRI的關系。結果 隨著尿管留置時間的延長,尿管內表面生物被膜活菌計數呈指數趨勢增長,CRI發生率有升高趨勢,各置管時段組間尿管內表面生物被膜活菌計數及CRI發生率比較差異均有統計學意義(Plt;0.05)。掃描電鏡見生物被膜的形成隨時間的延長而明顯增多。結論 細菌生物被膜形成是老老年患者留置尿管相關性尿路感染的重要致病因素,尿管留置時間越長,尿管生物被膜感染的危險性及幾率越高。更換尿管或縮短留置時間仍是防止尿管生物被膜感染的主要方法。
