【2017年整理】3.)交流+二等(抗菌药物在社区获得性军团菌肺炎治疗中的使用分析).doc

抗菌药物在社区获得性军团菌肺炎分析摘要目的38例军团菌肺炎的方法38例患者左氧氟沙星转归及临床分析。结果 38例患者痊愈左氧氟沙星总住院时间~56（23.5±13.5）d，治疗后。结论军团菌肺炎患者选用左氧氟沙星大环内酯类治疗，，。军团菌肺炎左氧氟沙星大环内酯类Analyses for the Usage of Antibiotic Drugs on Community-Acquired Legionella Pneumophila XUE Hong Yuan, Ge Xiang Hua, GAO Xiu Hua (Bethune International Peace Hospital, Shijiazhuang 050082, China　050082）evofloxacin combined antibiotic drug in the 38 cases of community-acquired legionella pneumophila, so as to provide basis for the treatment of the infection by legionella. Methods: Survey the clinical characteristic and effects, the combined antibiotic drugs, the course and cost of treatment, the adverse reactions after the 38 cases being treated with levofloxacin and other drugs. Results: After being treatmented, the effective rate was 100%. There was no serious adverse reaction. The temperature of the 38 cases were returned to normal after injecting levofloxacin for (2.18±1.10) days, and the total course of treatment in the hospital were 5~56 (23.5±13.5) days. Conclusion: The therapy of levofloxacin combined antibiotic drug for community-acquired legionella pneumophila is safe and effective. [KEY WORDS] community-acquired legionella pneumophila, levofloxacin, antibiotic drugs, sequential therapy, macrolides 社区获得军团菌肺炎（community-acquired legionella pneumophila，CALP）发病率在国LP临床表现复杂往往具有不典型性及易发生多脏器功能损害的特点临床上不易早期确诊院外可能有相当数量的病例漏诊、误治因此探讨本病的具有重要临床意义。符合LP诊断标准[1]进行综合分析1　临床资料 1.1　一般资料　3例LP患者男性年龄1～1.45±2.63）a。38例均符合1992年4月中华结核和呼吸杂志所制定的军团菌肺炎诊断标准[1]。1.2　临床症状和体征　均起病急骤，发体温39～40℃例，38～39℃ 1例，37～38℃例咳嗽4例，咳痰1例，咳血丝痰1例胸痛1例，胸闷气短例，头痛1例，恶心呕吐例腹痛腹泻例例例脾大例，脑膜刺激征例，肌肉关节疼例。呼吸困难气管切开机械通气。神志不清失语小便失禁 1.3 实验室检查　白细胞 10×109L 21 例， 10×109L 17 例。血沉 20 mm/h 28例，20～40mm/h 7例， 40mmh 3例例。血清钠降低例血清转氨酶 40 U 例酶200 U 例，肌酸磷酸激酶130 U 例例尿蛋白阳性例。低氧血症例。心电图窦性心动过速1例，心动过缓3例，心电图正常例。1.4　胸部表现　斑片状浸润阴影例多发小结节影6例例伴胸腔积液例。侧5例双侧例。 　治疗与转归　.1 临床表现 入院后体温在第（2.54±1.22）d降为正常。但后又有23人出现低热，出现次数为1~15次（平均2.87±3.17）次，其中。治疗～d后浸润阴影吸收例患者残留纤维条索状改变1例斑片影结节。1例.2 抗菌药物治疗 17例入院前曾用肌注或静例曾用治疗效～ d，9人因血像不高联合利巴韦林注射液，8人联合大环内酯类药物。确