| Objective: To investigate the efficacy of different infusion durations of imipenemcilastatin in the treatment of severe pneumonia.Methods:66cases of patients with severe pneumonia, were randomly dividedinto2groups.Experimental group was imipenem cilastatin0.5/2h infusion per6hadministration24h; the control group was imipenem cilastatin0.5/0.5h infusionadministered per6h24h,all were pumped through the micro-pump approach. Othertreatments were expectorant, life support and nutritional support and other symptomatictreatment. At last, the bacterial clearance rate and the average hospitalization time of thetwo groups were compared.Results:(1) Comparison of respiratory frequency The experimental groupconsisted of33±4beats/min before treatment down to18±1beats/min after treatment;The control group consisted of33±4beats/min down to19±2beats/min, after10days’treatment，The decrease of respiratory frequency was statistically significant differencebetween the two groups （P＜0.05）,The experimental group compared with the controlgroup, respiratoryfrequency decreased significantly.(2) Comparison of cough score Onthe fifth days, the experimental group from3.67±0.96points before treatment to2.50±0.73points, the control group from3.77±1.10points to2.73±0.87points，between thetwo groups before and after treatment, the difference was statistically significant (P <0.05),The cough symptoms of the experimental group and the control group were all improved,On the tenth day,the experimental group cough score dropped to1.27±0.64points, thecontrol group cough score dropped to1.33±0.61points, compare with the samegroup before treatment and the fifth day, the differences were statistically significant (P<0.05), For10days’ treatment, the cough symptoms of experimental group and thecontrol group were all improved, but the comparison between the two groups before and after treatment were no statistically significant (P>0.05), cough symptoms between thetwo groups had no significant difference.(3)The observation of inflammatory indexC-reactive protein in the experimental group from98.94±23.73mg/L before treatmentdecreased to8.31±4.66mg/L after treatment, in the control group from98.75±20.98mg/L decreased to21.85±11.80mg/L；The comparision of the experimental group and thecontrol group had no significant difference before treatment (P>0.05), after treatment, thedifferences had statistical significance (P <0.05), C-reactive protein in the experimentalgroup group is significantly lower than that in the control group.About PCT，experimentalgroup before treatment from5.04±1.99ng/ml fallen to0.38±0.25ng/ml after treatment;the control group from5.02±1.87ng/ml fallen to0.62±0.32ng/ml, The comparision ofthe experimental group and the control group before treatment had no significantdifference (P>0.05), the differences were statistically significant after treatment (P <0.05), the experimental group PCT is significantly lower than that of the control.(4) Thecomparison of PaO2Before treatment, PaO2in experimental group was66.17±8.02mmHg and64.93±8.49mmHg in the control group, no significant differences betweenthe two groups (P>0.05).After5days’ treatment, experimental group was72.96±4.93mmHg and70.10±5.59mmHg in the control group, the comparison of twogroups had statistical significance difference (P <0.05), PaO2in the experimentalgroup was obviously better than that of the control group.After10days’ treatment, theexperimental group was79.87±4.88mmHg,the control group was78.40±3.82mmHg,thedifferences had no statistical significance (P>0.05), No significant difference was foudin two groups about PaO2.(5)Comparision of clinical efficacy (efficiency) Aftertreatment, the efficiency of experimental group was87.88%, the control group was67.70%, there was significant difference between two groups (P <0.05), theexperimental group had higher efficiency than the control group.(6) The averagehospitalization days In the experimental group, the average hospital stay was10.5±1.7days, the control group mean hospital stay was12.2±1.9days, with significant differencebetween the two groups (P <0.05). In experimental group, the average hospital stay wasshorter than the control group.(7) Comparison of bacterial clearance rate After treatment, the experimental group bacterial clearance rate was86.36%, the bacterialclearance rate of control group was57.89%, with significant difference between the twogroups (P <0.05), the bacterial clearance rate in the experimental group was higher thanthat of the control group.Conclusion: Imipenem and cilastatin in the way of2hour infusion on severepneumonia’s treatment has better efficacy than that of0.5h infusion. |
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