Objective To study endotoxin release induced by differential antibiotics in gram negative bacterial infection. Methods Thirty critical patients accompanied with gram negative bacterial infection were divided into group A (imipenem group, n=15) and group B (ceftazidine group, n=15). Imipenem (0.5 g iv q8h) and ceftazidine (1.0 g iv q8h) were given respectively. White blood cell (WBC), systolic blood pressure (SBP), lipopoly sacchride (LPS), tumor necrosis factor alpha (TNFα) and high density lipoprotein (HDL) were determined in 0, 1, 2, 3, 5 and 7 day. Results There was no difference in the change of WBC between two groups. Group A had a more stable SBP than group B. There was lower endotoxin release in group A than in group B and so were the cytokines release. HDL level was lower in group B than in group A. Conclusion Imipenem has lower endotoxinliberating potential than ceftazidine and mediate lower cytokines release. HDL may protect the patients from LPS damage.
【摘要】 目的 总结2例特重烧伤患者在ICU的救治经验和体会，旨在进一步提高特重烧伤患者的救治水平。 方法 回顾分析2009年6月2例重症烧伤患者的诊治经过程和临床资料。 结果 1例患者病情好转，转出ICU继续治疗，1例患者伤后37 d因消化道出血死亡。 结论 特重烧伤患者的治疗需要整体计划和多科协作。【Abstract】 Objective To summarize the experiences of the management of two patients with severe burn, so as to improve the treatment of severe burn patients. Method Treating processes and clinical data of two patients with severe burn in June 2009 were analyzed retrospectively. Result After prompt treatments, one patient died of severe bleeding in the digestive tract 37 days after the burn and the other patient recovered and left ICU for further treatment. Conclusion Bundle treatment and multi-subject cooperation are important for treating patients with severe burn.