哌拉西林他唑巴坦联合环丙沙星治疗支气管扩张伴铜绿假单胞菌感染的临床研究

Clinical study on piperacillin tazobactam combined with ciprofloxacin in treatment of bronchiectasis with Pseudomonas aeruginosa infection

目的研究注射用哌拉西林钠他唑巴坦钠联合乳酸环丙沙星氯化钠注射液治疗支气管扩张伴铜绿假单胞菌感染的临床疗效。方法选取2016年2月—2017年2月在广汉市人民医院接受治疗的支气管扩张急性感染患者135例作为研究对象,根据随机数表法将患者分为对照组(67例)和治疗组(68例)。对照组静脉滴注乳酸环丙沙星氯化钠注射液,0.5 g/次,2次/d。治疗组在对照组患者治疗基础上静脉滴注予注射用哌拉西林钠他唑巴坦钠,1次/8 h,20~30 min。两组患者均连续治疗10~14 d。观察两组临床疗效,比较两组的细菌清除率和血清炎症指标。结果对照组和治疗组总有效率分别为79.10%、91.18%,两组比较差异具有统计学意义(P<0.05)。治疗后,对照组细菌清除率为67.16%,显著低于治疗组的82.35%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组白细胞计数(WBC)、C-反应蛋白(CRP)和降钙素原(PCT)水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组血清炎症指标水平均明显低于对照组,两组比较差异具有统计学意义(P<0.05)。结论注射用哌拉西林钠他唑巴坦钠联合乳酸环丙沙星氯化钠注射液治疗支气管扩张伴铜绿假单胞菌感染具有较好的临床疗效,提高细菌清除率,纠正炎症反应,具有一定的临床推广应用价值。

Objective To study the clinical effect of Piperacillin Sodium and Tazobactam Sodium for injection combined with Ciprofloxacin Lactate and Sodium Chloride Injection in treatment of bronchiectasis with Pseudomonas aeruginosa infection. Methods Patients（135 cases） with P. aeruginosa infection in Guanghan People＇s Hospital from February 2016 to February 2017 were randomly divided into control（67 cases） and treatment（68 cases） group. Patients in the control group were iv administered with Ciprofloxacin Lactate and Sodium Chloride Injection, 0.5 g/time, twice daily. Patients in the treatment group were iv administered with Piperacillin Sodium and Tazobactam Sodium for injection on the basis of the control group, once every 8 h, drop time 20 — 30 min. Patients in two groups were treated for 10 — 14 d. After treatment, the clinical efficacies were evaluated, and the bacterial clearance rate and serum inflammatory indexes in two groups were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 79.10% and 91.18%, respectively, and there was difference between two groups（P〈 0.05）. After treatment, the bacterial clearance rate in the control group was 67.16%, which was significantly lower than 82.35% in the treatment group, with significant difference between two groups（P〈 0.05）. After treatment, the WBC, CRP, and PCT levels in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈 0.05）. And the serum inflammatory markers in the treatment group after treatment were significantly lower than those in the control group, with significant difference between two groups（P〈 0.05）. There was no significant difference of adverse reaction between two groups. Conclusion Piperacillin Sodium and Tazobactam Sodium for injection combined with Ciprofloxacin Lactate and Sodium Chloride Injection has significant clinical effect in treatment of bronchiectasis with P. aeruginosa infection, and can effectively improve the bacterial clearance rate, correct the serum inflammatory markers, which has a certain clinical application value.