新生儿病房内采用单种抗生素治疗感染性疾病可行性探析.docVIP

新生儿病房内采用单种抗生素治疗感染性疾病可行性探析 　 作者：陈红兵，潘新年，沈开颜，白文静 【摘要】 目的：探讨新生儿病房内采用单种抗生素治疗新生儿感染性疾病的可行性。方法：随机选取在广西壮族自治区妇幼保健院住院的新生儿115例，对入选病例均采用单种抗生素治疗，对所有病例均行无菌操作。结果：115例患儿经单种抗生素规律治疗后，除2例新生儿脐膨出术后感染外，其他疾病的血白细胞计数和C反应蛋白均发生明显变化，经统计学分析有显著差异（Plt;0.05，Plt;0.01）；68例新生儿肺炎经1周治疗后，63例新生儿肺部炎症吸收好转，好转率92％；新生儿败血症患儿15例，血培养表皮葡萄球菌4例，金黄色葡萄球菌1例，大肠埃希菌2例，变形杆菌1例，经改用敏感抗生素治疗1周血培养阴性；脑脊液提示化脓性脑膜炎3例，选用透过血脑屏障的敏感药物治疗2周后复查脑脊液正常。结论：在合理安排床位、净化病房环境和无菌操作前提下，病房内采用敏感单种抗生素是可行的，避免了抗生素滥用，不会延长住院时间。 【关键词】 新生儿；抗生素；感染性疾病；病房 ［Abstract］ Objective:To explore the possibilities of treating infection diseases by adopting single antibiotics in neonatal wards.Methods:115 cases of neonates were randomly selected from neonatal wards of Guangxi Zhuang municipality maternity and children healthy hospital and treated with single antibiotics and germfree operation. Results:115 infection diseases treated with single antibiotics, with exception of 2 cases of postoperative infection of acromphalus, had obvious changes in their white blood cell (WBC) and Creactive protein (CRP) (Plt;0.05). One week after the treatment, 63 cases of neonatal pneumonia were with a recovery rate of 92%. Blood culture indicated there were 4 cases of staphylococcus epidermidis, 1 case of staphylococcus aureus, 2 cases of Escherichia coli and 1 of bacillus proteus, showing negative as a result of blood culture after one week of administration of sensitive antibiotics; 3 cases of purulent meningitis revealed by CSF were treated with sensitive antibiotics permeating bloodbrain barrier for 2 weeks and the result of CSF presented negative.Conclusions:Under reasonable sickbed arrangement, decontaminated environment and germfree operation, it is feasible to use senstive single antibiotics to treat neonatal infection diseases, which can avoid misuse of antibiotics, moreover, the hospitalization wont be prolonged. ［Key words］ Neonatal; Antibiotics; Infection diseases; Ward 抗生素是临床上治疗感染性疾病的必要手段，但目前滥用抗生素的问题愈来愈严重，抗生素之间配伍的合理性也愈来愈为各医院所重视，如何合理使用抗生素成为目前国内外关注的焦点。笔者在临床工作中采用单种抗生素治疗感