第三代头孢类抗菌药物对治疗肺癌术后感染患者的临床效果及对炎性应激状态的影响研究

Clinical effect of the third generation of cephalosporins in the treatment of patients with postoperative infections of lung cancer and its effect on inflammatory stress

目的研究第三代头孢类抗菌药物治疗肺癌术后感染患者的临床效果,探讨对炎性应激状态的影响。方法选取2015年1月-2016年12月收治的88例肺癌术后感染患者,随机分为试验组及对照组,每组44例;试验组患者静脉滴注头孢哌酮舒巴坦钠,对照组患者静脉滴注头孢呋辛;观察并记录两组患者症状改变情况及不良反应发生情况及术后1d、3d临床指标。结果试验组的有效率为88.64%,高于对照组的70.45%(P<0.05);与对照组比较,试验组的发热、痰中带血、咳嗽及肺部啰音或实变等症状改善时间均缩短(P<0.05);试验组术后并发症及不良反应发生率为4.55%,低于对照组的20.45%(P<0.05);在术后1d、3d时与对照组比较,试验组的IL-1、TNF-α、PCT及CRP表达水平均降低(P<0.05),IL-4、IL-10表达水平均升高(P<0.05)。结论第三代头孢类抗菌药物对肺癌术后感染患者有较好的临床效果,能够抑制患者炎性应激状态,有效改善患者症状,不良反应发生率较低。

OBJECTIVE To investigate the clinical effect of the third generation of cephalosporins in the treatment of patients with postoperative infections of lung cancer,and to explore the effect on the inflammatory stress.METHODS A total of 88 patients with postoperative infections of lung cancer from Jan.2015 to Dec.2016 treated in the hospital were chosen,and were randomly divided into experimental group and control group,with 44 cases in each group.Patients in experimental group were treated with intravenous infusion of cefoperazone sulbactam sodium,and in control group were given intravenous cefuroxime.The changes in symptoms and the occurrence of adverse reactions of the two groups were compared and record,and the clinical indexes at 1 dand 3 dafter operation of the patients were measured.RESULTS The effective rate of experimental group was 88.64%,which was significantly higher than 70.45% of control group（P〈0.05）.Compared with the control group,the improvement time of fever,sputum bloody,cough and lung rales or realities and other symptoms of experimental group were significantly shortened（P 0.05）.The incidence of complications and adverse reactions of experimental group was4.55%,which was significantly lower than 20.45% of control group（P〈0.05）.Compared with control group,the levels of IL-1,TNF-α,PCT and CRP in experimental group were significantly decreased at 1 dand 3 dafter surgery（P〈0.05）,and IL-4 and IL-10 were significantly increased（P〈0.05）.CONCLUSIONThe third generation of cephalosporins has a better clinical effect on lung cancer patients with postoperative infections,which can inhibit the patient＇s inflammatory stress state,effectively improve the symptoms of patients,and the incidence of adverse reactions is low.