头孢他啶在肺癌术后感染患者中的应用效果及对炎性应激状态的影响研究

Effect of ceftazidime on control of postoperative infections in lung cancer patients and influence on inflammatory stress

目的探讨头孢他啶在肺癌术后感染患者中的应用效果,研究对炎性应激状态的影响,为减少术后并发症提供参考依据。方法选取医院2012年1月-2015年6月肺癌术后感染患者100例,将患者随机分为试验组和对照组,每组各50例;试验组患者给予头孢他啶,对照组患者给予泰得欣,两组患者给药浓度均为2.0%,每天给药两次,连续给药1~2周;于术前、术后1、3、5d四个时间点测定血降钙素原（PCT）、C-反应蛋白（CRP）及肿瘤坏死因子α（TNF-α）表达水平,并检测白细胞计数、动脉血氧分压（PaO_2）氧合指数（PaO_2/FiO_2）。结果与术前相比,术后1、3d两组患者PCT、CRP、TNF-α表达水平及白细胞数均显著升高（P〈0.05）,术后5d两组患者PCT、CRP、TNF-α表达水平及白细胞数均恢复至正常;与术前相比,术后1、3d两组患者PaO_2、PaO_2/FiO_2水平均显著降低（P〈0.05）,术后5d两组患者PaO_2、PaO_2/FiO_2水平均恢复至正常;治疗前、治疗后各时间点,两组患者PCT、CRP、TNF-α表达水平、PaO_2、PaO_2/FiO_2水平及白细胞数均差异无统计学意义。结论头孢他啶在肺癌术后感染控制中具有良好的效果,能够有效抑制炎症应激状态,帮助患者术后肺部功能恢复。

OBJECTIVE To explore the effect of ceftazidime on control of postoperative infections in lung cancer patients and study the impact on inflammatory stress so as to reduce the incidence of postoperative complications.METHODS A total of 100 lung cancer patients complicated with postoperative infections who were treated in the hospital from Jan 2012 to Jun 2015 were enrolled in the study and randomly divided into the experimental group and the control group,with 50 cases in each.The experimental group was treated with ceftazidime,the control group was given Tazime,the dosing concentration of both groups was 2.0%,twice a day,continuous administration of 1-2weeks.The levels of serum procalcitonin（PCT）,C-reactive protein（CRP）,and tumor necrosis factorα（TNF-α）were determined before the surgery and after the surgery for 1,3,and 5days;the white blood cell counts,partial pressure of arterial oxygen（PaO_2）,and fraction of inspired oxygen（PaO_2/FiO_2）were detected.RESULTS The levels of PCT,CRP,and TNF-αand white blood cell counts of the two groups of patients were remarkably elevated after the surgery for 1and 3days（P〈0.05）;the levels of PCT,CRP,and TNF-αand white blood cell counts of the two groups of patients returned to normal after the surgery for 5days.The levels of PaO_2 and PaO_2/FiO_2 of the two groups of patients were significantly reduced after the surgery for 1and 3days（P〈0.05）;the levels of PaO_2 and PaO_2/FiO_2 of the two groups of patients returned to normal after the surgery for 5days.There was no significant difference in the level of PCT,CRP,TNF-α,PaO_2,PaO_2/FiO_2,or white blood cell counts between the two groups of patients at the time points.CONCLUSION The ceftazidime can achieve significant effect on control of postoperative infections in the lung cancer patients,effectively inhibit the inflammatory stress,and facilitate the recovery of lung function after the surgery.