罗红霉素联合哌拉西林舒巴坦治疗黏液型铜绿假单胞菌性肺炎的临床疗效观察

Clinical observation of roxithromycin combined with piperacillin/sulbactam in the treatment of mucinous Pseudomonas aeruginosa pneumonia

目的观察使用罗红霉素联合哌拉西林舒巴坦治疗黏液型铜绿假单胞菌性肺炎的临床疗效。方法 160例黏液型铜绿假单胞菌性肺炎患者作为研究对象,随机分为实验组和对照组,各80例。对照组单用哌拉西林舒巴坦抗感染治疗,实验组在对照组基础上加用罗红霉素口服联合抗感染治疗,观察并比较两组患者临床表现恢复情况、临床疗效以及不良反应发生情况。结果实验组患者体温恢复正常、咳嗽消失、啰音消失及白细胞计数恢复正常时间分别为(5.2±1.2)、(6.4±1.3)、(6.6±2.1)、(7.0±2.3)d,均短于对照组患者的(6.1±2.3)、(7.5±1.4)、(8.1±1.9)、(7.9±2.2)d,差异具有统计学意义(P<0.05)。实验组患者痊愈率和总有效率分别为56.3%(45/80)、88.8%(71/80),高于对照组患者的37.5%(30/80)、73.8%(59/80),差异有统计学意义(P<0.05)。实验组患者不良反应发生率为20.0%,低于对照组患者的25.0%,但差异无统计学意义(P>0.05)。两组患者不良反应均较轻,对症治疗后症状均缓解或消失。结论罗红霉素联合哌拉西林舒巴坦治疗黏液型铜绿假单胞菌性肺炎的临床疗效优于单用敏感类抗生素治疗,值得临床推广应用。

Objective To observe the clinical efficacy of roxithromycin combined with piperacillin/sulbactam in the treatment of mucinous Pseudomonas aeruginosa pneumonia. Methods A total 160 patients with mucinous Pseudomonas aeruginosa pneumonia as study subjects were randomly divided into experimental group and control group, with 80 cases in each group. The control group received piperacillin/sulbactam alone for antiinfection, and the experimental group received roxithromycin combined with oral anti-infection therapy on the basis of the control group. Observation and comparison were made on recovery of clinical manifestations, clinical efficacy and occurrence of adverse reactions between the two groups. Results The experimental group had body temperature back to normal, cough disappearance, rales disappearance and white blood cell count back to normal time respectively as(5.2±1.2),(6.4±1.3),(6.6±2.1) and(7.0±2.3) d than(6.1±2.3),(7.5±1.4),(8.1±1.9) and(7.9±2.2) d in the control group, and their difference was statistically significant(P<0.05). The experimental group had higher cure rate and total effective rate respectively as 56.3%(45/80) and 88.8%(71/80) than 37.5%(30/80) and 73.8%(59/80) in the control group, and their difference was statistically significant(P<0.05). The experimental group had lower incidence of adverse reactions as 20.0% than 25.0% in the control group, but the difference was not statistically significant(P>0.05). Both groups had mild adverse reactions, and symptoms relieved or disappeared after symptomatic treatment. Conclusion Combination of roxithromycin and piperacillin/sulbactam shows better clinical efficacy than sensitive antibiotics alone, and it is worthy of clinical promotion and application.