【摘要】 目的:探讨阿齐霉素加左氧氟沙星治疗传染性非典型肺炎(SARS)疑似病人的成本 效果。方法:静脉使用阿齐霉素加口服左氧氟沙星,根据病人对治疗的反应,将疑似SARS的75例病人分成SARS临床诊断病例组18例、非SARS组5 7例(SARS临床排除病例5 1例、疑似细菌性肺炎组6例) ,最后统计各组病人的发热天数、入院体温、退热时间、住院天数和总费用。结果:SARS组与非SARS组病人的年龄、入院体温无显著的统计学意义(P >0 .0 5 ) ;治疗3d ,非SARS组有5 1例病人基本排除SARS病例;最后非SARS组的住院时间为8.0±4 .0d ,明显低于SARS临床诊断病例组的13.4±4 .8d(P <0 .0 1) ;非SARS组的平均住院费用是4 973±3410元,明显低于SARS临床诊断病例组的736 3±2 835元(P <0 .0 1)。各组病人全部康复出院。追踪观察排除SARS患者中临床上没有漏诊1例SARS病人。治疗费用远远低于广州市参保非典病人和疑似病人平均医疗费用。结论:阿齐霉素针静脉滴注加口服左氧氟沙星,可以较快地从临床上排除SARS病例,而且费用低廉,符合基本保健制度的精神,是一种值得在临床继续使用、观察和完善的治疗方法。更多还原

【Abstract】 AIM: To explore the cost-effective quality about the treatment of azithromycin and levo-ofloxacin in suspected contagious atypical pneumonia (SARS) patients. METHODS: Azithromycin and levo-ofloxacin were administered intravenously and orally, respectively. All suspected SARS patients (n=75) were divided into three groups according to their responses to the therapy: clinically diagnosed patients (group A, n=18), clinically excluded patients (group B, n=51), and patients with suspected bacterial pneumonia (group C, n=6). Duration of fever, temperature at admission, time of fever reduction, duration of hospitalization and total expenditure were recorded for each patient. RESULTS: There were no differences (P>0.05) in age and temperature at admission between SARS group (group A) and non-SARS group (group B and C). 51 patients were excluded from SARS after 3-day treatment. The duration of hospitalization in non-SARS group was significantly shorter than that of group A ( 8.0 ± 4.0 days vs 13.4 ± 4.8 days, P< 0.01 ), and the total medical expenditure of the former was markedly lower than that of the latter (4973±3410 yuan vs 7363±2835 yuan, P< 0.01 ). All patients were restored well. A follow-up study showed that no patients of non-SARS group were misdiagnosed. The therapeutic expenditure for all 3 groups was far lower than the average cost for SARS and suspected SARS patients of Guangzhou City. CONCLUSION: Treatment with intravenous administration of azithromycin and oral administration of levo-ofloxacin provides an effective method to early exclude the SARS-free patients, and it is cheap according with the basic sanitary hygiene rules. This protocol deserves long-term clinical utilization, investigation and further improvement.更多还原