替加环素联合头孢哌酮舒巴坦钠治疗血液病患者多重耐药鲍曼不动杆菌感染的疗效观察

Tigecycline combined with cefoperazone sulbactam in the treatment of infection induced by multi-drug resistant Acinetobacter baumannii of blood disease patients

目的观察替加环素联合头孢哌酮舒巴坦钠治疗血液病患者多重耐药鲍曼不动杆菌感染的临床疗效。方法选取92例确诊为多重耐药鲍曼不动杆菌感染的血液病患者作为研究对象,按照血液疾病诊疗规范予以放化疗、免疫抑制剂、输血、调节免疫功能和维持水电解质平衡治疗;加强保护性隔离、严格消毒灭菌、清洁卫生等。对照组46例(男性22例,女性24例)给予头孢哌酮舒巴坦治疗,观察组46例(男性26例,女性20例)在对照组的基础上联合应用替加环素。记录2组治疗前、治疗7d后患者体温、白细胞计数(WBC)、降钙素原(PCT)、C反应蛋白(CRP)、急性生理与慢性健康评分(APACHEⅡ)变化;记录2组治疗7d后细菌清除率、治疗有效率及治疗28d病死率。结果经过7d治疗后,2组患者发热、感染相关指标、APACHEⅡ评分均较治疗前好转(P<0.05);与对照组治疗7d后相比,观察组好转更为明显(P<0.05)。观察组细菌清除率、治疗有效率均优于对照组(P<0.05),观察组28d病死率显著较低(P<0.05)。结论替加环素联合头孢哌酮舒巴坦治疗血液病患者的多重耐药鲍曼不动杆菌感染疗效显著,细菌清除率高,可降低病死率,值得在临床推广。

Objective To observe the clinical effect of tigecycline combined with cefoperazone sulbactam in treatment of infection caused by multi-drug resistant Acinetobacter baumannii of patients with blood disease.Methods Ninty-two cases of multi drug resistant Acinetobacter baumannii infected blood disease patients were randomly divided into two groups.Forty-six patients（22 males and 24 females）in the control group were treated with cefoperazone sulbactam,and 46 patients（26 males and 20 females）in the observation group were treated with tigecycline.The body temperature,WBC,PCT,CRP,APACHE II score were recorded before treatment and after 7-day treatment.After 7-day treatment,the bacterial clearance rate,treatment rate and the 28 days mortality rate were recorded.Results After 7-day treatment,fever,infection related indicators and APACHE II score in the two groups of patients were better than those before treatment（P〈0.05）;compared with the control group after 7-day treatment,the observation group improved more significantly（P〈0.05）.The bacterial clearance rate and treatment efficiency of the observation group were better than those of the control group（P〈0.05）,and the 28 days mortality rate of the observation group was significantly decreased（P〈0.05）.Conclusion Tigecycline combined with cefoperazone sulbactam is much better than cefoperazone sulbactam alone in the treatment of infection induced by multiple drug resistant Acinetobacter baumannii.