哌拉西林联合鱼油脂肪乳剂治疗重症医院获得性肺炎64例临床评价

Clinical Evaluation of Piperacillin Combined with Fish Oil Emulsion for Treating Severe Hospital Acquired Pneumonia in 64 Cases

目的探讨哌拉西林联合鱼油脂肪乳剂治疗重症医院获得性肺炎的临床疗效。方法选择2012年至2015年重症医院获得性肺炎患者128例,按随机数字表法分为对照组和治疗组,各64例。对照组患者给予静脉滴注哌拉西林,治疗组患者在给予哌拉西林静脉泵入后,加用鱼油脂肪乳剂静脉滴注。治疗14 d后,比较两组患者的临床疗效,检测治疗前后C反应蛋白(CRP)、氧合指数(PaO_2/FiO_2)、机械通气时间、抗菌药物使用时间、细菌清除率及炎性因子水平,记录发生的不良反应。结果治疗14 d后,治疗组总有效率为78.12%,显著高于对照组的56.25%(P<0.05);两组患者各观察指标及炎性因子水平均较治疗前显著改善(P<0.05),且治疗组改善程度更显著(P<0.05);两组不良反应发生率均较低,无明显差异(P>0.05)。结论持续静脉泵入哌拉西林联合鱼油脂肪乳剂治疗重症医院获得性肺炎临床疗效好,疗程短,不良反应少,值得临床推广。

Objective To investigate the clinical efficacy of piperacillin combined fish oil emulsion in the treatment of severe hospital acquired pneumonia. Methods Totally 128 patients with severe hospital acquired pneumonia from 2012 to 2015 were selected and randomly divided into the treatment group and the control group,64 cases in each group. The control group received intravenous infusion of piperacillin,on this basis,the treatment group was given intravenous infusion of fish oil emulsion. After 14 d of treatment,the clinical efficacy between the two groups was compared,the CRP,PaO_2/FiO_2,time of mechanical ventilation,time of antibiotics usage,rate of bacterial clearance and level of inflammatory factors were detected before and after treatment,and the incidence of adverse reactions was recorded. Results After 14 d of treatment,the total effective rate in treatment group was 78. 12%,which was significantly higher than56. 25% in control group（ P 0. 05）. The observed indexes and levels of inflammatory factors in the two groups were significantly better than those before treatment,and the treatment group was significantly improved than the control group（ P 0. 05）. The incidence rates of adverse reactions were very low in the two groups（ P 0. 05）. Conclusion Piperacillin combined fish oil emulsion in the treatment of severe hospital acquired pneumonia has good effect and short course of treatment with fewer adverse reactions,which is worthy of clinical promotion.