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目的 :探讨替加环素作为二线方案治疗血液病患者肺部感染的疗效及安全性。方法 :在血液病患者发生肺部感染时,使用一线抗感染药物治疗不能控制,病原学提示多重耐药或是临床高度怀疑多重耐药的情况下,经验性使用替加环素为二线治疗方案,并进行联合抗感染治疗。对临床资料进行分析,评价其治疗效果和不良反应。结果:50例患者中痊愈11例,显效11例,有效16例,无效8例;治愈率22%,总有效率76%。替加环素起效时间2~6 d(平均3.2 d)。死亡7例,其中有5例患者死亡与感染未控制有关,2例与感染无关。使用过程中患者最常出现的不良反应为恶性、呕吐、腹泻,一般经对症处理后均能耐受。结论:本研究结果显示,以替加环素为基础的经验性二线抗感染治疗方案在血液病肺部感染中获得较好疗效,且患者耐受良好,安全性较高。
Objective: To investigate the efficacy and safety of tigecycline as a second-line treatment of pulmonary infection in patients with hematological diseases. METHODS: Empiric use of tigecycline as a second-line treatment regimen was used empirically in the setting of lung infections in patients with blood diseases, uncontrollable use of first-line anti-infective medications, etiological cues for multiple drug resistance, or clinically highly suspected multi-drug resistance , And combined anti-infective treatment. The clinical data were analyzed to evaluate the treatment effect and adverse reactions. Results: In 50 cases, 11 cases were cured, 11 cases markedly effective, 16 effective and 8 ineffective. The cure rate was 22% and the total effective rate was 76%. The onset of tigecycline 2 ~ 6 d (average 3.2 d). Seven died, of which five died and the infection was uncontrolled, and two were unrelated to the infection. In the process of using the most common adverse reactions in patients with malignant, vomiting, diarrhea, usually symptomatic treatment can tolerate. CONCLUSIONS: The results of this study show that tigecycline-based empirical second-line anti-infective therapy is effective in the treatment of hematological lung infections and is well tolerated and safe.