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目的:探讨快速生长分枝杆菌血流感染的诊治方法。方法:通过1例骨折术后快速生长分枝杆菌血流感染的两次会诊实践,对治疗过程中不同阶段需要考虑的药物治疗问题进行总结分析。结果:第一次会诊,根据患者的血药浓度和肌酐清除率,优化了万古霉素给药剂量。第二次会诊,在患者症状和检验结果明显好转情况下,建议医生积极针对快速生长分枝杆菌进行抗感染治疗。建议停用抗结核药,改为克拉霉素联用阿米卡星后,患者病情好转出院。结论:对手术部位疑似、确诊快速生长分枝杆菌感染的病例,积极的干预和正确的诊治是成功的关键。
Objective: To investigate the diagnosis and treatment of rapid growth of mycobacterium infection in bloodstream. Methods: Two cases of mycobacterial bloodstream infection after fracture fracture were treated by two consultations, and the drug treatment problems to be considered in different stages of the treatment were summarized. Results: At the first consultation, the dose of vancomycin was optimized based on the patient’s plasma concentration and creatinine clearance. The second consultation, in patients with symptoms and test results significantly improved circumstances, it is recommended that doctors actively against the rapid growth of Mycobacterium anti-infective therapy. Proposed withdrawal of anti-TB drugs, changed to clarithromycin in combination with amikacin, the patient improved condition and discharged. Conclusion: It is the key to success that the suspected surgical site is suspected and rapid diagnosis of mycobacterial infection is made. Positive intervention and correct diagnosis and treatment are the keys to success.