To Explore The Influencing Factors Of Initial Empirical Treatment For Patients With Fever And Pulmonary Shadow

Objective:To explore the factors.influencing the efficacy of initial empirical treatment in patients with fever and pulmonary shadow,and to provide clinical reference for improving the success rate of initial treatment in such patients.Methods:Patients with fever and pulmonary shadow admitted to the department of respiratory medicine of the Second Affiliated Hospital of Kunming Medical University from April 2017 to April 2018 were selected.According to the initial treatment effect after admission,the patients were divided into the initial effective group and the initial ineffective group.The basic clinical data,peripheral blood leukocyte count and its classification,chest CT and other routine laboratory tests and imaging examination results of the two groups of patients were recorded,and the relevant data were statistically analyzed using SPSS23.0 statistical software.Results:1 A total of 201 patients with fever and pulmonary shadow were collected in this study,including 137 males and 64 females,aged 19-95 years,with an average age of(62.56-18.52)years.Among them,118 cases(58.7%)in the initial treatment effective group and 83 cases(41.3%)in the initial treatment ineffective group.2 The gender,age,smoking history,neutrophils,serum albumin,hemoglobin,blood glucose,serum sodium of this group of patients who with fever and pulmonary shadow have no correlation with the initial treatment ineffective(P>0.05),and white blood cells,the percentage of neutrophils,PCT,pleural effusion have correlation with the initial treatment ineffective(P<0.05),neutrophil percentage,pleural effusion as independent risk factors.3 The complications of this group of patients who with fever and pulmonary shadow mainly includes hypertension,coronary heart disease,pulmonary heart disease,diabetes mellitus,cerebral infarction,etc,among which diabetes mellitus was associated with initial treatment ineffective(P<0.05),but was not an independent risk factor.4 This study collected 201 cases of patients with fever and pulmonary shadow,antibiotics are used in every of them in initial treatment,discharge diagnosis included lung infection,and infection,pulmonary embolism,pulmonary tuberculosis,tuberculous pleurisy,lung cancer,pulmonary fibrosis,COPD,asthma,etc,among which tuberculosis was associated with initial treatment ineffective(P<0.05),and it was an independent risk factors.Conclusions:1 In this study,the initial empirical treatment response rate of 201 patients with fever and pulmonary shadow was 58.7%.2 The results of this study suggest that increased neutrophil percentage,pleural effusion and tuberculosis are independent risk factors for the initial ineffective treatment of patients with fever and pulmonary shadow.3 The results of this study suggest that diabetes mellitus,PCT level and white blood cell count are correlated with the initial treatment effect of patients with fever and pulmonary shadow,but they are not independent related factors.