基于蒙特卡罗模拟结果基础上合理应用亚胺培南的临床研究

Clinical Research of Applies Imipenem Reasonably Based on Monte Carlo in the Simulation

关键词:  亚胺培南  蒙特卡罗模拟  延长给药时间

Key words:  imipenem  Monte Carlo Simulation  extension gives the medicine time

摘要:

目的 探讨不同病情下采用蒙特卡罗模拟结果应用亚胺培南的治疗效果。方法 选择367例感染患者，治疗前对患者进行APACHEⅡ评分，<20分患者延长给药时间组73例，常规给药组70例，≥20分患者延长给药时间组114例，常规给药组110例，延长给药时间组参考蒙特卡罗模拟结果，给予亚胺培南/西司他丁[0.5 g，1次·(6 h)^-1]，并且将总输注时间延长至3 h，常规给药组给予亚胺培南/西司他丁[0.5 g，1次·(6 h)^-1]，每次输注时间30 min。两组都给予相关的高级生命功能支持及营养支持，其余辅助治疗相同。结果 APACHEⅡ评分<20分患者采用亚胺培南延长给药时间与常规给药方法疗效、预后、住院时间无统计学差异；而APACHEⅡ评分≥20分患者采用亚胺培南延长给药时间的给药方法在疗效、预后、住院时间皆优于常规给药方法。结论 在危重感染的情况下延长亚胺培南滴注时间的给药方法可使患者获得更大的益处，这也为合理应用亚胺培南提供依据。

Abstract:

OBJECTIVE Discusses under the different condition to use Monte Carlo the Simulation result to apply imipenem the treatment result. METHODS Chooses 367 infection patients, before the treatment carries on APACHE to the patientⅡGrading, <20 patient lengthens for the medicine time group 73 examples, the convention for the medicine group 70 examples, ≥20 patient lengthens for the medicine time group 114 examples, the convention gives the medicine group 110 examples, The extension refers to Monte Carlo for the medicine time group the Simulation result, and gives imipenem 0.5 g, q6h to lengthen the total infusion time to 3 h, the convention gives for the medicine group imipenem 0.5 g, q6h, each time infusion time 30 min.Two groups both give the correlation the high-level life function support and the nutrition support, other assistances treat same. RESULTS APACHEⅡGrades <20 to divide the patient to use imipenem to lengthen for the medicine time and the convention gives the formula law curative effect, the prognosis, in hospital time non-statistics difference; But APACHEⅡA grading ≥20 minute patient uses imipenem to lengthen for the medicine time for the formula law in the curative effect, the prognosis, in hospital time all surpasses the convention to the formula law. CONCLUSION Lengthens the imipenem drop note time in the seriously injured infection situation to be possible to cause the patient for the formula law to obtain a bigger profit, this also for reasonably provides the basis using imipenem.