碳青霉烯类双联治疗铜绿假单胞菌肺炎的临床研究

Clinical Research on Carbapenem Bigeminy in Treatment of Pseudomonas Aeruginosa Pneumonia

目的分析铜绿假单胞菌肺炎应用碳青霉烯类双联治疗的临床效果。方法选取2015年12月—2017年12月在该院诊治的128例铜绿假单胞菌肺炎患者临床资料,按不同治疗方案分2组,各组64例,对照组给予头孢哌酮钠舒巴坦钠治疗,观察组给予碳青霉烯类双联(亚胺培南-西司他丁钠+美罗培南)治疗,比较两组临床疗效、血清指标及肺功能。结果观察组治疗总有效率90.63%比对照组71.88%高(χ~2=7.384 6,P<0.05);观察组治疗后铜绿假单胞菌阳性率9.38%比对照组37.50%少(χ~2=14.106 1,P<0.05);观察组治疗后WBC(6.23±0.80)×109/L、CRP(3.90±0.45)mg/L、PCT(0.25±0.07)g/L均比对照组少(t=9.984 1,30.424 6,38.655 0,P<0.05)。结论铜绿假单胞菌肺炎应用碳青霉烯类双联治疗能有效改善肺炎症状,提高病菌转阴率,减轻炎症反应,改善肺部功能,效果显著。

Objective To analyze the clinical effect of carbapenem bigeminy in treatment of pseudomonas aeruginosa pneumonia. Methods 128 cases of patients with pseudomonas aeruginosa pneumonia admitted and treated in our hospital from December 2015 to December 2017 were selected and divided into two groups with 64 cases in each, the control group were treated with cefoperazone sodium, while the observation group were treated with carbapenem bigeminy（imipenem-C lastatin sodium ＋ meropenem）, and the clinical curative effect, serum index and lung function were compared between the two groups. Results The total treatment effective rate in the observation group was higher than that in the control group（90.63% vs 71.88%）（χ2=7.384 6,P〈0.05）; after treatment, the positive rate of pseudomonas aeruginosa in the observation group was lower than that in the control group（9.38% vs 37.50%）（χ2=14.106 1,P〈0.05）; and the WBC（6.23±0.80）×109/L, CRP（3.90±0.45）mg/L, PCT（0.25±0.07）g/L in the observation group after treatment were lower than those in the control group（t=9.984 1, 30.424 6,38.655 0,P〈0.05）. Conclusion The application of carbapenem bigeminy in treatment of pseudomonas aeruginosa pneumonia can effectively improve the pneumonia, improve the bac terial negative-conversion rate, relieve the inflammatory reactions and improve the lung function and the effect is obvious.