头孢哌酮舒巴坦联合替加环素治疗鲍曼不动杆菌所致重症肺炎的临床研究

Clinical and laboratory study of cefoperazone sulbactam combined with tegafur in the treatment of severe pneumonia caused by Acinetobacter baumannii in Bauman

目的研究头孢哌酮舒巴坦联合替加环素治疗鲍曼不动杆菌所致重症肺炎临床与实验室指标。方法以2018年1月1日-2019年12月31日期间在本院就诊的鲍曼不动杆菌所致重症肺炎患者120例为研究对象,随机分为观察组与对照组各60例,对照组给予头孢哌酮舒巴坦抗感染治疗,观察组在对照组基础上加用替加环素,治疗7d后比较两组的微生物清除率、治疗有效率、超敏C反应蛋白、白细胞计数、机械通气时间及平均住院天数等指标。结果治疗7 d后,两组降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、白细胞计数(WBC)及APACHEⅡ评分均明显低于治疗前(P<0.05);且观察组各指标显著低于对照组(P<0.05);治疗后观察组治疗有效率98.3%,显著高于对照组的86.7%(P<0.05);细菌清除率为75.0%,明显高于对照组56.7%(P<0.05);ICU停留时间、平均住院天数及呼吸机使用时间均明显低于对照组(P<0.05)。结论头孢哌酮舒巴坦联合替加环素治疗鲍曼不动杆菌所致重症肺炎可有效缓解病情,提高细菌清除率,缩短ICU停留时间及平均住院天数,治疗效果显著,值得临床参考借鉴。

Objective To study the clinical and laboratory indexes of cefoperazone sulbactam combined with tegafur in the treatment of severe pneumonia caused by Acinetobacter baumannii in Bauman.Methods From January 1,2019 to December 31,2018 in our hospital for treatment of severe pneumonia caused by Acinetobacter Bauman in 120 patients as the research object,randomly divided into observation group and control group with 60 cases in each group,the control group was given cefoperazone sulbactam anti infection treatment,the observation group in the control group based on the use of tigecycline therapy.After 7 days,compared with two groups of microbial clearance rate,treatment efficiency,Chao Min C,C-reactive protein,white blood cell count,mechanical ventilation time and the average hospitalization days were.compared.Results After 7d treatment,two groups of procalcitonin(PCT)levels and high-sensitivity C reactive protein(hs-CRP)and white blood cell(WBC)count and APACHE score were significantly lower than before treatment(P<0.05);And the indicators in the observation group were significantly lower than the control group(P<0.05);After treatment,the effective rate of treatment was 98.3%,significantly higher than the control group 86.7%(P<0.05);the bacterial clearance rate was 75%,higher than the 56.7%of control group(P<0.05);The ICU residence time,average hospitalization time and ventilation time were significantly lower than the control group(P<0.05).Conclusion Cefoperazone sulbactam combined with tigecycline in treatment of drug resistant Acinetobacter Bauman induced severe pneumonia can alleviate the condition,improve the bacterial clearance rate,shorten the residence time of ICU and the average hospitalization days,can significantly improve the treatment effect,it is worthy of clinical reference.