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目的探讨ICU重症感染患者的抗菌治疗前后痰培养病原菌动态变化及临床疗效,从而为ICU重症感染患者提供针对性的治疗方案。方法选择2012年9月-2015年2月医院接诊的80例ICU重症感染患者进行研究,将其随机分为观察组、对照组,每组各40例,对照组给予常规治疗,观察组针对性的实施抗菌药物治疗,记录分析患者在治疗前后的痰液菌群动态变化,观察比较两组患者的疗效。结果患者治疗总有效率观察组达97.50%,显著高于对照组的47.50%,两组比较差异有统计学意义(χ2=4.084,P<0.05);对照组的起效时间要明显长于观察组,观察组在咳嗽、咳痰、体温等症状消失时间均显著短于对照组,两组患者起效时间与症状消失时间比较差异有统计学意义(P<0.05)。结论 ICU重症感染患者在抗菌治疗前痰培养病原菌以鲍氏不动杆菌为主,治疗后铜绿假单胞菌和鲍氏不动杆菌所占比例相对较高,对ICU重症感染患者实施针对性的抗菌药物治疗,可以缩短起效时间及症状消失时间,效果显著,值得在临床推广应用。
Objective To investigate the dynamic changes of sputum culture pathogens and their clinical efficacy before and after antibacterial therapy in patients with severe ICU infection so as to provide targeted treatment for patients with severe ICU infection. Methods Eighty patients with severe ICU admitted to the hospital from September 2012 to February 2015 were selected and randomly divided into observation group and control group, 40 cases in each group. The control group was given routine treatment. The observation group was given The implementation of antibacterial drug therapy, recording and analysis of patients before and after treatment of sputum flora dynamic changes observed and compared the efficacy of two groups of patients. Results The total effective rate of treatment group was 97.50%, which was significantly higher than that of the control group (47.50%), the difference was statistically significant (χ2 = 4.084, P <0.05); the onset time of the control group was significantly longer than that of the observation group , The observation group in the cough, sputum, body temperature and other symptoms disappeared significantly shorter than the control group, the two groups of patients with onset time and symptoms disappear time was significantly different (P <0.05). Conclusion The main pathogens of sputum culture in patients with severe ICU infection are Acinetobacter baumannii before antimicrobial therapy. After treatment, the proportion of Pseudomonas aeruginosa and Acinetobacter baumannii is relatively high, and the patients with ICU severe infection are targeted Antibacterial drug treatment, can shorten the onset time and symptoms disappear time, the effect is significant, it is worth in the clinical promotion and application.