哌拉西林/他唑巴坦治疗小儿恶性实体瘤相关肺部感染的疗效评价

Evaluation of Piperacillin/tazobactam in the Treatment of Pediatric Malignant Solid Tumor Associated Pulmonary Infection

目的:评价哌拉西林/他唑巴坦治疗小儿恶性实体瘤相关肺部感染的疗效和安全性。方法:小儿外科收治的恶性实体肿瘤患儿68例,根据痰培养和药敏结果将患儿分成两组:哌拉西林/他唑巴坦钠治疗治疗组(n=38)与头孢米诺钠治疗组(n=30),疗程均为7-14天。比较两组患儿症状、体征、血白细胞、C反应蛋白及痰培养恢复情况及疗效。结果:两组治疗前后C-反应蛋白(t=0.239,P=0.812)、白细胞计数(t=0.656,P=0.514)及中性粒细胞百分比(t=1.501,P=0.138)的变化对比;两组临床有效率分别为94.74%和93.33%(X^2=0.060,P=0.807),上述差异均无统计学意义;而两组治疗时间比较差异有统计学意义(t=2.424,P=0.018)。两组痰培养致病菌均以铜绿假单胞菌为首,细菌清除率分别为84.38%和76.00%,差异无统计学意义(F=0.634,P=0.446)。两组用药过程中均无不良反应发生。结论:哌拉西林/他唑巴坦在小儿恶性实体瘤化疗过程中出现的肺部感染的治疗中疗效明显,安全性好。

Objective： To evaluate the curative effect and safety of Piperacillin/tazobactam in the treatment of pediatric malignant solid tumor （PMST）-associated pulmonary infection. Methods： The 68 children with solid tumors were collected from September 2012 to 2014 September. According to the sputum culture and sensitivity results, the children were divided into two groups, Piperacillin/tazobactam treatment group （n=38） and Cefininox sodium treatment group （n=30）. The treatment lasted for 7-14 days. Compare the symptoms, signs, white blood cells, C-reactive protein and sputum culture results between the two groups. Results： There were no statistically significant differences in C-reactive protein （t = 0.239, P = 0.812）, white blood cell count （t = 0.656, P = 0.514） and neutrophil percentage （t = 1.501, P = 0.138） in two groups between before and after the treatment. The clinical effective rates of the two groups was respectively 94.74% and 93.33% （chi-square = 0.060, P = 0.807）, having no statistical difference. But there was significant difference in the time of therapy between the two groups （t = 2.424, P = 0.018）. Pseudomonas aeruginosa was found as the primary cultivated pathogenic bacteria in both groups, but there was no statistical difference in bacterial clearance rate between two groups （F = 0.634, P = 0.446）, which was 84.38% and 76.00% respectively. No adverse reactions occurred in the treatment of PMST-associated pulmonary infection in two groups. Conclusions： With the obvious curative effect and favorable safety, Piperacillin/tazobactam can be used in the treatment of PMST-associated pulmonary infection.