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目的分析探讨血液病合并发热患者抗菌药物应用的现状。方法采用整体分析方法,调查我院血液科血液病患者108例的抗菌药物使用情况,并对抗菌药物的品种、用药频度和病原学检测进行分析。结果85.2%(92/108)患者体温高于38℃,其中恶性血液病85例(78.7%)。进行病原体培养者39例(36.1%),其中致病菌生长25株(64.1%),前三位依次为肺炎克雷伯菌(9株),铜绿假单胞菌(7株),假丝酵母菌(4株)。所有患者均接受抗菌药物治疗,共涉及9类31种。最常用的前5种抗菌药物依次为哌拉西林(45例)、左氧氟沙星(38例)、头孢哌酮(36例)、亚胺培南(28例)、甲硝唑(25例)。91.7%(99/108)患者为2种以上抗菌药物联合应用,50.9%(55/108)患者为3种以上抗菌药物联合应用。结论血液病合并发热患者多数为中等度以上发热,进行病原菌检测的例数较少,抗菌药物多数为两种药物联合应用。
Objective To analyze the status of antimicrobial agents in patients with hematological diseases and fever. Methods The overall analysis was used to investigate the use of antibacterials in 108 patients with hematological hematological diseases in our hospital. The antibacterials were analyzed for their breed, frequency of use and etiological tests. Results In 85.2% (92/108) of the patients, the temperature was higher than 38 ℃, of which 85 cases (78.7%) had hematologic malignancies. Pathogen culture was performed in 39 cases (36.1%), of which 25 (64.1%) were pathogenic bacteria, followed by Klebsiella pneumoniae (9 strains), Pseudomonas aeruginosa (7 strains) Yeast (4 strains). All patients received antimicrobial therapy, involving a total of 31 species in 9 categories. The top five most commonly used antibiotics were piperacillin (45 cases), levofloxacin (38 cases), cefoperazone (36 cases), imipenem (28 cases) and metronidazole (25 cases). 91.7% (99/108) patients were combined with 2 or more antibiotics, and 50.9% (55/108) patients were combined with 3 or more antibiotics. Conclusions The majority of patients with hematological fever with fever are moderate to moderate fever with few cases of pathogen detection. Most antibacterials are used in combination with two drugs.