目的:探索磷霉素抗生素锁技术(antibiotic lock technology,ALT)在治疗导管相关感染中的作用及给药方式对临床疗效的影响。方法:选取43例患者作为研究对象,均为2012年1月至2014年4月在九江学院临床医学院附属医院治疗的导管相关感染的血透患者,将其随机分为A(n=14)、B(n=7)、C(n=8)、D(n=14)四组,观察各组治疗效果。A组患者单药每日2次,B组患者单药每日1次,C组患者联合用药(磷霉素+单药)每日各1次,D组患者为未封管处理。结果:①导管感染的前四位细菌共41例,占95.3%,依次为金黄色葡萄球菌、表皮葡萄球菌、除表皮的凝固酶阴性葡萄球菌、大肠埃希菌,磷霉素的敏感率均较高,分别为82.3%、71.4%、73.3%、96.5%;②不同的给药方式影响治疗效果。联合给药组血培养转阴时间最短(P〈0.05);体温下降速度最快(P〈0.05);但各组间白细胞总数及中性比的下降速度无差异(P〉0.05)。结论:磷霉素可作为是早期用药的选择,磷霉素锁技术中的联合用药能提高治疗效果,血培养转阴时间及体温下降速度可作为疗效观察指标。
Objective: To explore the effect of the antibiotic lock technique (ALT) in the treatment of catheter related infection and its effect on the clinical efficacy.Methods: 43 catheter-related infections patients were selected as the research object, from January 2012 to April 2014 in Jiujiang University Hospital for the treatment of hemodialysis, and randomly divided into A (n=14), B (n=7), C (n=8), D (n=14) four groups, the therapeutic effects were observed. Patients in group A were treated with single medicine 2 times a day, 1 times a day in group B, patients in group C were treated with combination therapy (P+1), D group was not sealed.Results: The results of catheter infection four bacteria were 41 cases, accounting for 95.3%, followed by Staphylococcus aureus, Staphylococcus epidermidis, in addition to the epidermis of coagulase negative staphylococcus, Escherichia coli, fosfomycin sensitive rate were higher, respectively 82.3%, 71.4%, 73.3%, 96.5%. Blood culture conversion in combination group is the shortest (P〈0.05); temperature decreased the fastest in combination group among all groups (P〈0.05); but the white blood cell count and the ratio of the neutral rate of decline had no difference (P〉0.05).Conclusion: Fosfomycin as early drugs of choice, in combination lock technology improve the therapeutic effect. Blood culture negative time and temperature drop speed can be used as the efficacy index.