儿童肺炎克雷白杆菌肺炎临床特点及耐药性研究.docxVIP

儿童肺炎克雷白杆菌肺炎临床特点及耐药性研究 杨华 湖南省凤凰县人民医院416200 【摘 要】目的探讨儿童肺炎克雷白杆菌肺炎临床特点及耐药性的状况， 从而为该疾病合理应用抗牛素提供依据。方法选取我院2010年1月?2013年1 月诊断为肺炎克雷白杆菌肺炎的患儿60例进行临床特点分析，并对所有患儿的 耐药性进行分析。结果木组患儿主要临床表现为咳嗽、气促喘息、肺部可闻及 广泛的湿罗音、痰鸣音和哮鸣音；辅助检查：白细胞升高者18例，正常者32 例，降低者10例；影像学表现：10例大叶性肺炎，35例支气管肺炎，15例肺 间质改变和肺纹理增粗；木组疾病最敏感的抗牛素为亚胺培南■西司他丁钠、哌 拉西林/他哇巴坦等；木组患儿最常用的抗牛素为哌拉西林/他卩坐巴坦，并且临床 疗效好，不良反应少。结论肺炎克雷白杆菌肺炎多发生于婴儿，起病急，病情 重，在对该疾病治疗时应监测耐药性，根据药敏结果选择抗生素，大多数患儿临 床疗效好，预后良好。 【关键词】儿童肺炎克雷白杆菌肺炎；临床特点；耐药性 Objective to in vestigate the clin ical features and drug resista nee of Klebsiella pneumoniae pneumonia in children, and to provide evidence for rational use of antibiotics.Methods in our hospital in January 2010 January ?2013 diagnosis of Klebsiella pneumonia in children with 60 cases of clinical characteristics analysis, and all the patients with drug resista nee an alysis.Results in this group, with the main clinical manifestations of cough, shortness of breath, wheezing, lung can be heard and a wide range of moist rales, phlegm wheezing sound and wheezing sound； auxiliary examinati on： white cells in creased in 18 cases, no rmal in 32 cases, decreased in 10 cases, imaging manifestations： 10 cases of lobar pneumonia, 35 cases of bronchial pn eumonia, 15 cases of pulm on ary in terstitial cha nges and lung markings thickening； this group of diseases is the most sensitive antibiotics imipenem - west our he Ding sodium, piperacillin, piperacillin / he tazobactam.The group of children with the most commonly used antibiotic piperacillin / sulbactam cilostazol tazobactam and clinical efficacy, adverse reactions less.Conclusion Klebsiella Bacillus pneum onia multiple was bor n in in fants, acute on set, severe illn ess, in the surveillanee of drug resistance in the treatment of the disease, the choice of antibiotics according to the result of drug sensitivity, most children with good clinical efficacy, the prog nosis is good. Key words children pneumonia Klebsiella pneumonia clinical characteristics of drug resista nee 肺炎是指不同病原体或其他因素(如