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[中性粒细胞减少和免疫功能低下患者的细菌感染治疗]

[Therapy of bacterial infections in neutropenic and immunocompromised patients].

作者信息

Helbig W, Tauchnitz R

机构信息

Klinik für Innere Medizin, Universität Leipzig.

出版信息

Z Gesamte Inn Med. 1992 Sep;47(9):417-21.

PMID:1441670
Abstract

Neutropenias, especially extended an long-lasting stages, lead to life-threatening endogenous infection. Therefore, after taking off materials for bacteriological investigations an empirical schedule of a combined high dose, treatment with broad-band antibiotics and/or antimycotics has immediately to be introduced and to continue until the body temperature and the peripheral blood granulocytes are normalized. In case of treatment failure one should complete the therapy by other additional antibiotics or correct the combination of its in respect to the results of the microbiological investigations. Supplements of this antimicrobial treatments are immunoglobulins and growth factors (G-CSF, GM-CSF). In case of an expected neutropenica the use of the selective gut decontamination or the reverse isolation of the patient can be of essential advantage.

摘要

中性粒细胞减少症,尤其是持续时间延长且持久的阶段,会导致危及生命的内源性感染。因此,在采集用于细菌学检查的材料后,必须立即开始经验性的高剂量联合治疗方案,使用广谱抗生素和/或抗真菌药进行治疗,并持续至体温和外周血粒细胞恢复正常。如果治疗失败,应根据微生物学检查结果,使用其他额外的抗生素完成治疗或调整联合用药方案。这种抗菌治疗的补充剂是免疫球蛋白和生长因子(G-CSF、GM-CSF)。在预期会出现中性粒细胞减少的情况下,使用选择性肠道去污或对患者进行反向隔离可能具有重要优势。

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