Objective: To effectively improve the utilization rate of shared medical equipment in hospitals, and enable efficient sharing and scientific allocation of equipment resources, so as to maximize the social and economic benefits of shared medical equipment. Methods: According to the characteristics of shared medical equipment, four modes were adopted to manage the benefits of shared medical equipment, namely, special management and sharing, fixed base, turnover lease and complementary coordination. Establish the benefit evaluation system of shared medical equipment, and make reasonable suggestions through analysis and comparison, and promote the application in the whole hospital. Results: Since the implementation of classified and centralized management of shared medical equipment, the amount of equipment leased, the use time of equipment, and the cost recovery of equipment investment have increased year by year. By reasonably controlling the quantity and quality of idle equipment, the waste of idle equipment is effectively avoided, the workload of equipment maintenance is reduced, and the operation cost is reduced. Conclusion: The enthusiasm of all departments to fully rent equipment has been enhanced to ensure the maximum performance of equipment.

目的 研究41个单基因高血压相关致病基因与子痫前期的关联,观察基因变异对子痫前期患者胎盘微血管生成和外周T细胞亚型的影响.方法 收集入选志愿者外周血并记录临床资料,采用相关致病基因Panel对2016年9月至2019年4月住院的109例子痫前期患者和47例因非患病原因需剖宫产的产妇(对照组)进行基因谱分析;用免疫组化检测部分子痫前期患者(29例)及对照产妇(27例)胎盘组织血管内皮生长因子(VEGF)表达和计数胎盘微血管密度(MVD),用流式细胞仪检测外周血T细胞亚型.结果 与对照组比,子痫前期组磷酸二酯酶3A(PDE3A)基因变异频率低(0.9％比8.5％,x2=6.103,P=0.029),磷酸二酯酶11A(PDE11A)和赖氨酸缺陷蛋白激酶 1(WNK1)基因变异频率高(25.5％比6.4％,X2=7.148,P=0.008;19.3％比4.3％,X2=5.887,P=0.015).29例子痫前期患者的PDE11A基因9个外显子位点变异为:c.1825G＞T、c.755C＞T、c.604C＞T、c.2071G＞A、c.1921A＞G、c.2599C＞G、c.305G＞T、c.935T＞A 和 c.2757-2758insTCC.21 例子痫前期患者的 WNK1 基因7个外显子位点变异为:c.4564G＞A、c.446C＞T、c.6707C＞T、c.1922A＞T、c.1748-1749insA、c.2220-2221insC 和c.2175-2176insC,经多重评分软件检测,这些变异大多存在致病性.WNK1野生型对照(n=29)、WNK1野生型子痫前期(n=17)和WNK1变异型子痫前期(n=10)三组胎盘MVD比较显示,WNK1变异型子痫前期组比野生型子痫前期和对照组都低(均P＜0.05),野生型子痫前期组和对照组间的差异无统计学意义.二元logistic回归分析显示,在调整了年龄、血压、糖尿病、肥胖、胎龄和胎儿体质量因素后,胎盘MVD与WNK1基因变异负相关(OR=0.86,95％CI 0.75～0.99,P=0.04);三组胎盘VEGF阳性率比较显示,WNK1变异型子痫前期组低于对照组(70％比100％,X2=8.815,P=0.017),而对照组与野生型子痫前期组对比差异无统计学意义(100％比94.7％,x2=1.453,P=0.858).PDE11A基因变异与子痫前期组T细胞亚型变化关系不明确.结论 WNK1和PDE11A基因变异可能与子痫前期相关,WNK1基因变异可能对胎盘微血管生成有影响.

Objective:To systematically assess the effect of electrical impedance tomography (EIT) guided positive end-expiratory pressure (PEEP) titration on patients with acute respiratory distress syndrome (ARDS) / acute respiratory failure (ARF).Methods:Systematic searches were performed in the PubMed, Embase, Web of science, Cochrane library, CNKI, VIP and Wanfang databases for articles published up to March 10, 2020 about effects of EIT guided PEEP titration on ARDS / ARF patients. Two reviewers independently screened articles, extracted data and evaluated the quality of included studies. Then meta-analysis was conducted using RevMan 5.3 software.Results:Seven articles with 147 patients were enrolled in this study. Meta-analysis showed that compared with traditional PEEP setting methods (ARDS network, pressure / volume curve, flow rate / volume curve), the PEEP [mean difference (MD) = 2.35, 95% confidence interval (CI) (0.38, 4.32), Z = 2.34, P = 0.02] and oxygenation index [MD = 26.63, 95%CI (7.89, 45.38), Z = 2.78, P = 0.005] were higher, and the lung compliance [MD = 5.06, 95%CI (2.49, 7.62), Z = 3.86, P = 0.000 1] was better in ARDS / ARF patients with EIT guided PEEP titration. However, there was no significant difference in the mean arterial pressure [MD = -0.97, 95%CI (-6.31, 4.36), Z = 0.36, P = 0.72] and in-hospital mortality [odds ratio = 0.40, 95%CI (0.14, 1.12), Z = 1.74, P = 0.08] between the EIT guided PEEP titration and traditional PEEP setting methods.Conclusion:Compared with traditional PEEP setting methods, EIT guided PEEP titration can improve the PEEP, oxygenation index and lung compliance, but has no significant effect on the mean arterial pressure and in-hospital mortality of ARDS / ARF patients.

目的 探索凝血指标抗凝血酶Ⅲ(ATⅢ)在急性肺动脉血栓栓塞症(PTE)中的临床应用价值.方法 采用回顾性研究方法,纳入2012年5月至2019年6月福建省立医院收住的204例已确诊的PTE患者,研究资料包括患者基本情况、基础疾病及入院24 h内实验室检查、评分系统,分析ATⅢ与PTE院内死亡及不良事件之间的关系,并进一步探究ATⅢ优化危险分层的价值.结果 ATⅢ水平预测PTE患者院内死亡率的受试者工作特征曲线下面积(AUC)为0.719,其中截断值为77.7％(敏感性64.71％,特异性80.21％).根据截断值水平分为ATⅢ≤77.7％组(n=48)及ATⅢ＞77.7％组(n=156),慢性心力衰竭、白细胞计数、血小板计数、谷丙转氨酶、白蛋白、肌钙蛋白Ⅰ组间差异有统计学意义(P＜0.05).据院内死亡情况分为死亡组(n=17)与存活组(n=187),比较白细胞计数、ATⅢ、D-二聚体、谷丙转氨酶、白蛋白、肾小球滤过率、APACHE Ⅱ评分组间差异有统计学意义(P＜0.05).Logistics回归分析发现ATⅢ≤77.7％、白细胞计数为院内死亡的独立危险因素.运用受试者工作特征曲线分别对危险分层及危险分层联合ATⅢ进行院内死亡预测,AUC分别为0.705、0.813,差异有统计学意义(P＜0.05).进一步采用列线图展示危险分层联合ATⅢ新评分模型.结论 ATⅢ≤77.7％是院内死亡的独立危险因素,并有利于优化危险分层,其机制可能与血栓形成、右心功能障碍及炎症反应等有关.

目的 探讨中性粒细胞与淋巴细胞比值(neutrophil-to-lymphocyte,NLR)、淋巴细胞与单核细胞比值(lymphocyte-to-monocyte ratio,LMR)、血小板与淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)、乳酸脱氢酶(LDH)与胃癌根治术后患者预后的相关性.方法 收集110例在我院胃肠外科行根治性胃癌手术患者的病理学资料及随访资料,利用Kaplan-Meier法计算生存率,Log rank检验分析不同分组之间的差异,应用Cox回归分析影响根治性胃癌术后预后的因素.结果 随访病例共110例,其中Ⅰ～Ⅱ期40例,Ⅲ期70例.全组患者随访13～96个月,中位随访时间为80.9个月.110例随访患者中,有44例死于胃癌,66例仍生存.对不同临床病理因素胃癌患者的生存情况进行分析显示,不同TNM分期、淋巴结转移、NLR和LDH水平的胃癌患者预后的差异具有统计学意义(均P<0.05),而不同年龄、性别、肿块大小、分化程度、PLR和LMR水平的患者预后的差异无统计学意义(P>0.05).不同NLR、PLR水平患者的肿瘤分化程度差异明显(均P<0.05);不同LMR、LDH水平患者的TNM分期不同(均P<0.05);LDH还与PT分期即局部浸润程度有关,差异具有统计学意义(P<0.05).对影响胃癌患者预后的变量进行Cox多因素回归分析结果显示,TNM分期、NLR水平和LDH为影响胃癌患者预后的独立因素(均P<0.05).结论 TNM分期、NLR水平和LDH为影响胃癌患者预后的独立因素.

目的 探究新型炎症指标单核细胞计数(monocyte)与高密度脂蛋白(high density lipoprotein,HDL)比值(monocyte/HDL ratio,MHR)与急性肺栓塞(acute pulmonary embolism,APE)病情严重程度及院内病死率的关系.方法 采用回顾性队列研究方法,选择2012年5月至2019年3月福建省立医院收治的286例APE患者,收集入组患者年龄、基础疾病等基本信息,进行血白细胞计数(WBC)、单核细胞计数、HDL、肌钙蛋白(cTn)及D-二聚体等实验室检查,计算MHR,分析不同病情严重程度院内生存和死亡患者的MHR水平.结果 根据院内生存情况分为生存组(n=271)及死亡组(n=15),两组患者年龄、高血压、糖尿病及脑梗死等基础疾病比较差异无统计学意义(P＞0.05),血WBC、单核细胞计数、白蛋白、HDL及MHR等差异有统计学意义(P＜0.05).利用上述指标绘制受试者工作特征曲线(ROC曲线)对院内病死率进行预测,曲线下面积(AUG)最大分别为血WBC 0.798,MHR 0.675.根据MHR截断值0.37分为MHR＞ 0.37组及MHR≤0.37组,发现MHR＞ 0.37组患者D-二聚体、cTn水平明显高于MHR≤0.37组,分别为[4.08(1.91,7.54)vs.2.59(0.72,5.41)]、[0.02(0.00,0.09)vs.0.02(0.00,0.02)],差异有统计学意义(P＜0.05).根据《2019年欧洲心脏病协会与呼吸协会共同制定的急性肺栓塞诊断与管理指南》[1]中危险分层将APE患者分为高危、中高危、中低危及低危.中低危、中高危及高危组患者MHR水平明显高于低危组患者,差异均有统计学意义(P值分别为0.003、0.022、0.004).应用二元Logistic回归分析发现,MHR、血WBC、D-二聚体与肌酐(Cr)升高及HDL降低均为APE患者院内死亡的独立危险因素.结论 MHR、血WBC、D-二聚体与血Cr升高及HDL降低均是APE院内死亡的独立危险因素;中危及高危APE患者MHR水平高于低危患者,MHR可以预测APE患者病情严重程度.

目的 分析个体化延续护理在急诊高血压患者健康教育中的应用效果.方法 抽取2018年3月至2019年1月阶段以急诊方式入院治疗的高血压患者68例,按照随机原则将其分为观察组(包含34例)和对照组(包含34例).对照组患者给予常规健康教育,观察组则给予个体化延续健康教育干预.结果 患者的舒张压水平、收缩压水平控制效果,护理前两组患者均相当,P＞0.05差异不显著;但护理后观察组的控制效果显著优于对照组,P＜0.05差异显著.比较两组患者的疾病知识掌握率、用药依从性和护理满意度等护理指标,观察组均明显比对照组更高,P＜0.05差异显著.结论 在急诊高血压患者健康教育中实施个体化延续护理,能够显著改善患者的血压管理能力,从而促使患者获得更加显著的血压控制效果,获得患者更高的护理认可度.

目的:对于2型糖尿病失眠患者开展中医护理干预的具体措施以及对患者血糖和睡眠质量指数所产生的影响进行分析与总结.方法:选取2017年1月至2018年1月福建医科大学附属协和医院中医科收治的2型糖尿病失眠患者资料100例,采取随机数字表法分为观察组和对照组,对照组患者接受常规护理措施,观察组患者接受中医护理干预措施,比较2组患者接受不同护理措施之后的血糖水平以及睡眠质量指数差异情况.结果:2组患者接受不同护理措施之后的血糖水平比较,差异有统计学意义(P＜0.05);2组患者的睡眠质量指数比较,差异有统计学意义(P＜0.05).结论:临床中针对2型糖尿病失眠患者,为其提供中医护理干预措施效果理想,能够改善患者的血糖水平,保障患者的睡眠质量,应该给予大力的推广与应用.

目的:探讨急诊护理流程优化对急诊患者急救效果和护理满意度的影响作用.方法:选取笔者所在医院急诊科2015年6月-2016年6月收治的各类急诊急救患者100例作为研究对象,以对照试验要求为依据,随机将其分为观察组和对照组,每组50例.对照组实施常规急诊护理流程,观察组实施优化急诊护理流程.结果:观察组患者分诊评估时间、心电监护时间、静脉采血时间、静脉用药时间和治疗时间均明显短于对照组,差异均有统计学意义(P<0.05);观察组患者急救成功率为98.0％,高于对照组的90.0％,差异有统计学意义(P<0.05).观察组患者及其家属对急诊健康教育、治疗性护理、服务态度、心理护理等护理满意度评分均高于对照组,差异均有统计学意义(P<0.05).结论:急诊护理流程优化能够显著提高患者的急救效果,从而提高患者的抢救效果,降低患者的死亡率,促使患者更快恢复,显著提升患者的护理满意度.

目的:探讨品管圈活动在降低乳腺癌患者PICC导管相关性感染中的应用效果.方法:收集2014年1月~2015年12月PICC导管相关感染发生的情况,分析乳腺癌患者PICC导管相关感染发生的原因,并制定对策,实施改善方案,制定护理标准.结果:活动前773例患者中发生导管相关感染32例,发生率为4.13‰,其中导管穿刺处局部感染25例(3.23‰)、导管隧道感染2例(0.25‰)、导管相关性血流感染5例(0.64‰);活动后761例患者中发生导管穿刺处局部感染13例(1.70‰)、导管隧道感染1例(0.13‰),导管相关性血流感染1例(0.13‰);品管圈活动的干预显著降低了导管相关感染的发生率,活动前后差异有统计学意义(P<0.05).分层回归分析表明,品管圈活动对乳腺癌患者PICC导管相关性感染的干预效果与职业因素及居住地相关,其中品管圈活动对家庭主妇患者、长期居住于乡镇患者的干预效果相较于非家庭主妇患者、长期居住于城镇患者具有显著的统计学意义(P<0.05).结论:品管圈活动可以降低乳腺癌患者PICC导管相关感染的发生率,提高护士及患者对PICC导管的维护意识,从而提高安全给药的指数及患者的生存质量.PICC导管的护理质量亦是衡量专科护理水平的重要指针,通过品管圈活动可以提高护士解决问题的能力,使其在工作中获得成就感,提高安全意识和责任心,从而提高专科护理质量,同时也提升了团队的合作精神.

目的 研究在糖尿病护理管理中应用全程健康教育模式的意义.方法 选取该科2015年1月-2016年12月收治的200例糖尿病患者,借助于数字随机表法将其列入观察组(合计100例)和对照组(合计100例),对照组与观察组分别应用常规健康教育模式与全程健康教育模式,对两组的护理效果进行对比分析.结果 两组护理有效率对比,观察组(94.0%)显著高于对照组(79.0%),差异有统计学意义(P<0.05);两组糖尿病疾病知识知晓情况对比,观察组显著优于对照组,差异有统计学意义(P<0.05).结论 在糖尿病护理管理中应用全程健康教育模式能够有效地提高患者对于疾病知识的认知水平,改善降糖效果,可推广.

OBJECTIVE To evaluate the effect of Kudiezi Injection on CYP450enzyme activity by cocktail probe drugs in male SD rats.METHODSWTBZ Male SD rats were randomly divided into four groups(each n=5),including hig h-dose group,low-dose group of Kudiezi Injection,positive control group (Phe nobarbital),blank control group.A series of cocktail probe drugs including dap sone(10mg·kg-1),and chlorzoxazone(10mg·kg-1) were respectively in fused into abdominal cavity of rats in the morning of d15 as the probes of cytoc hrome P450(CYP) enzyme isoform of CYP3A4 and CYP2E1 after multiple dosing of Kud iezi Injection.The plasma concentrations of the two probes were determined by H PLC and their corresponding pharmacokinetic parameters were calculated to evalua te the possible effect of Kudiezi Injection extracts on CYP450 enzyme activity.RESULTS AUC0-t,AUC0-∞ and the concentration of chlorzoxazone were decreased significantly (P<0.05) and the CL was increased in rats after Kudiezi Injection for 14 consecutive days,in compa ring with the blank control group.The activities of the CYP2E1 in the rats rece ived Kudiezi Injection were significantly enhanced (P<0.05).CONCLUSION Kudiezi Injection had obvious induction on CYP2E1 in rats.

目的 探讨多因素对恶性实体瘤合并弥散性血管内凝血治疗疗效的影响.方法 选取2006年9月至2016年9月间收治的167例恶性实体瘤合并弥散性血管内凝血患者,对其进行病因治疗,抗凝和(或)替代治疗等对症治疗后,观察临床效果,并分析多因素对治疗有效率的影响.结果 167例DIC患者,以消化道肿瘤和肺癌较为多见.年龄≥60岁组的DIC患者治疗有效率高于<60岁组(52.0%VS 28.3%,P<0.05).合并感染的患者治疗有效率低于不合并感染的患者,但差别无统计学意义(34.7%VS 44.9%,P>0.05).无瘤负荷DIC患者治疗有效率明显高于有瘤负荷DIC患者(82.9%VS 27.3%,P<0.05).在无瘤负荷组,抗凝治疗和替代治疗疗效无明显差异(P>0.05);在有瘤负荷组,抗凝组疗效高于替代治疗组(33.7%VS 6.5%,P<0.05).在DIC治疗有效的患者中,有瘤负荷组接受>6150 IU抗凝剂量所占比例明显高于无瘤负荷组(61.1%VS24.1%,P<0.05).结论 恶性实体瘤合并弥散性血管内凝血转归受多因素影响.在治疗原发病的同时,适量的抗凝治疗是提高治疗有效率的重要手段.

目的：探讨预见性护理在急诊科脑卒中患者中的应用价值。方法：选择2014年1月-2016年1月笔者所在科室收治的100例脑卒中患者作为研究对象，将入选的研究对象根据临床护理方式分为两组，即观察组和对照组，每组50例。对照组患者给予急诊科常规护理，观察组患者给予预见性护理干预。结果：观察组患者的临床治疗总有效率为96.0%，高于对照组患者的84.0%，差异有统计学意义(P<0.05)；观察组患者肺部感染、下肢深静脉血栓、压疮、尿路感染、应激性溃疡等并发症发生率低于对照组患者，差异有统计学意义(P<0.05)；观察组患者出院后1个月和6个月时的复发率均为0，低于对照组患者的8.0%和14.0%，差异均有统计学意义(P<0.05)。结论：预见性护理的实施能够显著提高急诊科脑卒中患者的整体临床治疗效果，显著降低患者的并发症发生率，降低患者治疗后的复发率，具有非常显著的应用效果，值得在临床上进行推广应用。

Objective To explore the therapeutic effect and safety of bevacizumab combined with chemotherapy in previously treated advanced patients with non?small cell lung cancer ( NSCLC) . Methods In this study, 84 patients pathologically in accordance with the feature of advanced NSCLC were treated with bevacizumab combined with chemotherapy from May 2010 to July 2014. The cur?ative effect was analyzed according to Response Evaluation Criteria in Solid Tumors ( RECIST) 1?1 every 2 cycles. The National Cancer Institute Common Toxicity Criteria ( NCI?CTC) version 3?0 was employed to evaluate the adverse reaction. Survival analysis was per?formed using Kaplan?Meier method. Results All the 84 patients were evaluable for response. There were no CR cases, 12 cases of PR, 42 cases of SD and 30 cases of PD with the response rate and disease control rate of 14?8% and 64?8%. The median progression free survival and overall survival were 3?8 months and 8?8 months, respectively. The main adverse reactions of bevacizumab were hy?pertension, bone marrow suppression, liver function damage and skin rash, manifested most as degree 1?2 but rarely degree 3?4. Con?clusion It was effective and safe for advanced NSCLC patients treated with bevacizumab combined with chemotherapy.

目的：为实现护士对患者相关信息和药物条形码的准确核对，创造性地采用二维条形码的解决方案，确保了急诊静脉滴注流程的准确性和安全性。方法利用条形码技术的准确性、信息的快速收集、大量的信息收集、方便等特点，以提供一种识别手段，和相关联的设备组成自动识别系统，进行资源提供和整合。结果应用条形码的二维双联标签，执行静脉滴注医嘱准确、快捷和方便患者的静脉滴注安全得到进一步保障。结论系统通过二维条形码扫描技术的应用，使患者身份与药物产生唯一配对标识，做到患者和静脉滴注药品唯一的匹配，通过对条形码扫描核对条形码双联静脉滴注标识，从而绕过判断和识别的人工环节，增强了安全性，杜绝静脉滴注用药差错的发生，实现护理安全控制操作风险。

Objectives: To explore the relationship between vascular active peptide, apelin level and blood pressure in a coastal population of Fujian province. <br> Methods: A total of 1031 subjects with the mean age of (55.1 ± 10.9) years in a coastal area of Fujian province were included in this cross-sectional study, and 416 subjects with male gender. The questionnaire survey, physical examination and plasma level of apelin measurement were conducted. Based on JNC-7 deifnition of hypertension, the subjects were divided into 3 groups: ① Hypertension group, the patients with systolic blood pressure (SBP)≥140 mmHg and/or diastolic blood pressure (DBP)≥90 mmHg, n=496. ② Pre-hypertension group, SBP at (120-139) mmHg and/or DBP at (80-89) mmHg without medication, n=314.③Normal BP group, SBP<120mmHg and DBP<80mmHg without medication, n=221. Based on 4 quartiles of apelin levels, the subjects were further divided into 4 groups:Q1 group, apelin<164.8 ng/ml, n=258. Q2 group, apelin at (164.8-<220.0) ng/ml, n=258. Q3 group, apelin at (220.0-283.1) ng/ml, n=258. Q4 group, apelin>283.1 ng/ml, n=257. One way analysis of variance, covariance analysis and multivariate linear regression analysis were used to study the <br> relationship between apelin level and BP. <br> Results: The apelin level in male gender (220.57 ± 78.87) pg/ml was lower than female gender (232.06 ± 81.17) pg/ml. Compared with Normal group, Pre-hypertension group had decreased apelin level, compared with Normal and Pre-hypertension groups, Hypertension group had decreased apelin level, P<0.05. Compared with Q1 group, Q2, Q3 groups presented decreased SBP, DBP and mean arterial blood pressure (MABP), and compared with other 3 groups, Q4 group had decreased SBP, DBP (not including Q2, Q3 groups) and MABP, P<0.05. With adjusted age and gender, SBP, DBP and MABP were signiifcantly different among 4 quartiles of apelin groups, P<0.05. Multivariate linear regression analysis indicated that SBP, DBP and MABP were negatively related to apelin level, such relationship remained the same after adjusting the other cardiovascular risk factors. <br> Conclusion: Apelin level dropping accompanying with BP increasing implies that vascular active peptide, apelin involved in BP regulation.

目的:检测多发伤患者早期凝血、抗凝及纤溶相关性指标变化,并探讨其临床意义. 方法:采用前瞻性、单中心、随机对照临床试验,收集 2012 年 9 月至 2014 年 8 月本院多发伤患者 84 例,分为脏器功能不全组(n = 43)、脏器功能正常组(n = 41)及对照组(n = 39). 检测 3 组各指标: PT、APTT、TT、vWF、FIB、D-D、AT:A、PLG:A、PLT.结果:与对照组比较,前两组中PT、APTT、TT、vWF、FIB、D-D均明显升高(P <0.05),而AT:A、PLG:A、PLT 均明显降低(P < 0.05); 与脏器功能正常组比较,脏器功能不全组 PT、APTT、TT、vWF、FIB、D-D均明显升高(P < 0.05),而AT:A、PLG:A、 PLT均明显降低(P < 0.05).结论:监测多发伤患者早期机体凝血、抗凝及纤溶相关性指标,有助于了解机体凝血功能状态,预防DIC发生,改善多发伤患者预后.

通过结合1例吸毒合并肺部感染重症患者诊疗过程，认为临床药师必须充分发挥专业优势与医师形成互补的治疗团队，成为疑难重症疾病救治团队中的一员。

<正>癫痫为多种原因导致脑部神经元高度同步化异常放电的临床综合征,脑内兴奋递质过多或抑制性递质过少,及使用兴奋与抑制失衡的药物均可引起癫痫发作。据统计[1,2]诱发癫痫的抗菌药物以氟喹诺酮类及碳青霉烯类(主要为亚胺培南/西司他丁)居多,故临床在选用药物治疗时应充分考虑患者病史,权衡利弊。笔者以临床实践中癫痫合并感染患者为例,针对碳青霉烯类药物美罗培南与癫痫的关系进行分析与探讨。