碳青霉烯类双联治疗铜绿假单胞菌的临床疗效

Clinical effect of carbapenem combined therapy on Pseudomonas aeruginosa

目的分析并探讨碳青霉烯类双联治疗铜绿假单胞菌的临床效果,并对其安全性进行评估,进而为临床治疗方案的选择提供依据。方法选取2016年5月—2017年5月江油市九〇三医院收治的铜绿假单胞菌肺炎患者120例,根据随机数字表法将其分为对照组和研究组,各60例。对照组患者给予头孢哌酮钠舒巴坦钠2 g,静脉滴注,每天3次;研究组给予碳青霉烯类双联法治疗,静脉滴注亚胺培南-西司他丁钠1 g,以及美罗培南500 mg,每天3次。连续治疗15 d为1个疗程。比较两组患者的治疗效果,观察并详细记录患者的两组患者细菌的清除情况,采用问卷调查的形式对患者的社会功能、躯体功能、角色功能以及认知功能进行评分。结果研究组的治疗总有效率为91.6%,对照组总有效率为78.3%,研究组有效率明显高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者的生活质量评分无明显区别;治疗后,研究组患者的生活质量评分明显高于对照组,差异有统计学意义(P<0.05)。治疗后,研究组细菌清除率(80.0%)明显高于对照组(66.7%),差异有统计学意义(P<0.05)。结论使用碳青霉烯类双联法对铜绿假单胞菌肺炎患者进行治疗,可有效地清除患者体内的细菌,提高患者的生活质量,该治疗方法临床效果显著,相比较其他的治疗方法更有应用价值,症状改善明显,且安全性高,值得临床推广。

Objective To analyze and explore the clinical effect of carbapenem combined therapy on Pseudomonas aeruginosa, and to evaluate its safety and provide the basis for the selection of clinical treatment regimen. Methods A total of 120 patients with Pseudomonas aeruginosa pneumonia treated in our hospital from May 2016 to May 2017 were randomly divided into control group and study group, with 60 cases in each group. The patients of the control group were treated with routine treatment, while patients of the study group were treated with carbapenem combined therapy. The therapeutic effects of the two groups were compared. Results The total effective rate of the study group was 78.3%, and 91.6% in the control group. The effective rate of the study group was significantly higher than that of the control group（P〈0.05）. Before treatment, there was no significant difference in the quality of life scores between the two groups. After treatment, the quality of life of the study group was significantly higher than that of the control group（P〈0.05）. After treatment, the bacterial clearance rate in the study group was significantly higher than that of the control group. Conclusion The treatment of patients with Pseudomonas aeruginosa pneumonia by carbapenem combined method can effectively remove the bacteria and improve the quality of life of the patients. The clinical effect of carbapenem combined therapy is significant, compared with other methods of treatment, which has application value, can improve symptoms significantly, with high security, is worthy of clinical promotion.