亚胺培南/西司他丁延长输注时间对重症泛耐药鲍曼不动杆菌临床疗效的影响

The clinical efficacy of imipenem/cilastatin with prolonged the infusion time on the treatment of severe pan-resistance Acinetobacter baumannii

目的观察比较替加环素联合亚胺培南/西司他丁、亚胺培南/西司他丁联合头孢哌酮舒巴坦、延长亚胺培南/西司他丁静脉滴注时间联合头孢哌酮舒巴坦对重症泛耐药鲍曼不动杆菌疗效的影响。方法选取重症医学科重症泛耐药鲍曼不动杆菌肺部感染患者36例,随机分为试验1、2、3组,每组12例,分别给予替加环素联合亚胺培南/西司他丁、亚胺培南/西司他丁联合头孢哌酮舒巴坦、延长亚胺培南/西司他丁静脉滴注时间联合头孢哌酮舒巴坦治疗,比较3组的临床疗效、细菌学疗效、试验室数据、评分系统变化。结果试验3组总有效率为66.7%,高于试验1、2组的58.3%和50.0%(P<0.05)。试验1、2组总有效率比较差异无统计学意义(P>0.05)。试验3组细菌总清除率为58.3%,高于试验1、2组的41.7%和16.7%(P<0.05)。试验1、2组总有效率比较差异有统计学意义(P<0.05)。治疗后,3组T、WBC、N%、PCT、APACHEⅡ评分均低于治疗前,差异有统计学意义(P<0.05)。结论亚胺培南/西司他丁输注3 h能改善重症泛耐药鲍曼不动杆菌感染患者的疗效,适合应用于临床治疗中。

Objective To observe and compare the clinical efficacy of tigecyclinc combined with imipenem/cilasta- tion, imipenem/cilastation combined with cefoperazone sulbacta, prolonging intravenous infusion of imipenem/cilastatin com- bined with cefoperazone sulbactam on severe pan-resistance Acinetohacter baumannii. Methods 36 patients with severe pul- monary infection were randomly divided into trial group 1,2 and 3 with each group of 12 patients and ticyclinc combined with imipenem/cilastatin,imipenem/cilastatin combined with cefoperazone sulbactam, imipenem/cilastatin with prolonged intrave- nous infusion time combined with cephalosporins Paclitaxel were given each of these 3 groups respectively （ P 〈 0.05 ）. The clinical efficacy, bacteriological efficacy and laboratory data, changes of scoring system were compared. Results The clinical effective rate of group 3 were 66.7% ,higher than group 1 and group 2 with effective rate of 58.3% and 50.0% respectively. The total clearance rate of bacteria in group 3 was 58.3% ,which was higher than that in experimental group 1 and group 2 with 41.7% and 16.7% respectively. The difference of effective rate between the two groups was significant （P 〈0.05 ）. The lev- els of temperature, WBC, N% , PCT APACHE lI of the three groups were significantly decreased compared to those before treatment, and the difference is statistically significant （ all P 〈 0.05 ）. Conclusion 3 hours of Imipenem/cilastatin infusion can improve the efficacy in treatment of severe pan-resistant patients with Acinetobacter baumannii infection, and it is suitable for analving to clinical treatment.