《中国康复理论与实践》

《中国康复理论与实践》 ›› 2012, Vol. 18 ›› Issue (5): 444-447.

• 论文 • 上一篇    下一篇

预防性抗生素应用对重症脑卒中急性期感染和预后的影响

王强，马剡芳，左鹰，李建国，刘易新，张龙友，于东明   

  1. 首都医科大学附属北京天坛医院急诊科，北京市 100050。
  • 收稿日期:2012-03-26 修回日期:1900-01-01 出版日期:2012-05-25 发布日期:2012-05-25
  • 通讯作者: 20120514.PDF

Effects of Antibiotic Prophylaxis on Infection and Prognosis after Severe Stroke

WANG Qiang, MA Shan-fang, ZUO Ying, et al.   

  1. Emergency Department of Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
  • Received:2012-03-26 Revised:1900-01-01 Published:2012-05-25 Online:2012-05-25

PDF (PC)

摘要： 目的探讨预防应用抗生素对重症脑卒中急性期感染和预后的影响。方法165 例病程24 h 内的急性脑卒中患者随机分为试验组和对照组，试验组早期给予头孢呋辛钠3 g、甲硝唑0.5 g 静脉滴注，每日2 次，或莫西沙星0.4 g 静脉滴注每日1 次。监测体温、C-反应蛋白(CRP)、白细胞计数、胸片变化，主要终点为急诊期间感染，次要终点为急诊死亡和急性期预后。结果试验组感染率(P=0.58)、感染确诊时间(P=0.74)、急诊死亡率(P=1.00)和平均死亡时间(P=0.84)、体温(P=0.99)、CRP(P=0.37)、白细胞计数(P=0.51)、格拉斯哥昏迷评分(P=0.31)和急性生理和慢性健康状况评估(APACHE-Ⅱ)评分(P=0.28)均与对照组无显著性差异。结论预防应用抗生素不能降低急性脑血管感染率及严重程度，也不改善急性期预后。

关键词: 脑卒中, 感染, 预防性抗生素

Abstract: Objective To investigate the effects of antibiotic prophylaxis on the incidence of infection and prognosis in acute phase aftersevere stroke. Methods 165 patients within 24 h from clinic onset were divided into the intervention group and control group. The interventionincluded cefuroxime+metronidazole or moxifloxacin. The body temperature was continuously monitored, and the presence of infectionwas daily assessed with C-reactive protein (CRP), leukocyte count, and bedridden X-ray. They were also assessed with Glasgow ComaScale (GCS) and Acute Pathologic and Chronic Health Evaluation (APACHE)-Ⅱ. Primary end points was incidence of infection; secondaryend points included death and other clinical outcome. Results There was no difference between tow groups in infection rate (P=0.58), intervaluntil diagnosis of infection (P=0.74), so as mortality (P=1.00) and interval of death (P=0.84), body temperature (P=0.99), CRP (P=0.37) , leukocyte (P=0.51), scores of GCS (P=0.31) and APACHE-Ⅱ (P=0.28). Conclusion Antibiotic prophylaxis works little to prevent infectionand improve outcome in patients with acute stroke.

Key words: stroke, infection, antibiotic prophylaxis