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目的探讨晚期癌症合并感染患者不同抗菌药物治疗方法与效果。方法回顾性调查我科2004年1月至2005年6月68例82例次癌症并发感染患者,分析感染部位构成比及易感因素个数,治疗开始即采用广谱抗菌药物组(A)与窄谱抗菌药物组(B)、降阶梯治疗组(a)与升阶梯治疗组(b)的疗程和疗效。结果感染部位以呼吸道感染最多见,占68.29%;易感因素个数a组与b组差异有显著性(P<0.05);各组疗程差异均无显著性,但B、b组治疗后体温及中性粒细胞比值下降幅度较大;a组总有效率高,而且治疗达到治愈或好转所需时间短(P<0.05)。结论降阶梯疗法不增加细菌耐药性的发生,可减少或避免反复盲目调换抗菌药物及联合用药的毒副作用,缩短了疗程,节约了费用,严重感染的患者,感染来势凶猛而尚无病原学及药敏结果时,抗感染降阶梯治疗是最佳选择。
Objective To investigate the treatment methods and effects of different antibiotics in patients with advanced cancer complicated with infection. Methods A retrospective survey of 82 patients with concurrent cancer in 68 cases of cancer from January 2004 to June 2005 in our department was conducted to analyze the constituent ratios of infection sites and the number of predisposing factors. At the beginning of treatment, a broad-spectrum antibacterial drug group (A) Narrowband antibacterial drug group (B), step-down treatment group (a) and step-up treatment group (b) course of treatment and efficacy. Results The most common infection was respiratory infection, accounting for 68.29%. The number of susceptible factors was significantly different between group a and group b (P <0.05), but there was no significant difference between the groups And neutrophil ratio decreased significantly; a group of total effective rate, and treatment to achieve cure or improvement of the time required for a short time (P <0.05). Conclusion The descending ladder therapy does not increase the incidence of bacterial resistance, can reduce or avoid repeated blindly replace the side effects of antimicrobial agents and combination therapy, shorten the course of treatment, save costs, patients with severe infections, the infection fierce and yet no pathogens And drug susceptibility results, anti-infective down the ladder treatment is the best choice.