喜炎平联合阿米卡星不同给药方式治疗铜绿假单胞菌肺部感染疗效和安全性分析

Analysis on curative effects and safety of different administration methods of Xiyanping combined with Amikacin in treatment of pulmonary infection of pseudomonas aeruginosa

目的分析喜炎平联合阿米卡星不同给药方式治疗铜绿假单胞菌肺部感染疗效和安全性。方法选取我院2017年10月~2018年10月收治的92例铜绿假单胞菌肺部感染患者,将患者采用随机数字表法分为试验组及对照组各46例。试验组雾化吸入"7.5mg/kg阿米卡星溶解到20mL浓度为0.9%的氯化钠注射液中,2次/d,20min/次";对照组静脉使用阿米卡星15mg/(kg·d),一日不超过1.5g;两组均联合应用喜炎平治疗,共1周,辅以祛痰、体外引流、纠正水电解质酸碱平衡紊乱、营养支持等治疗。比较两组患者的肺功能改善情况、病原微生物(铜绿假单胞菌)浓度、治疗效果以及不良反应发生情况。结果试验组治疗后1周及6个月的FEV1、DLCO水平均高于对照组,差异有统计学意义(P <0.05);试验组治疗后1周及6个月的原微生物(铜绿假单胞菌)浓度均低于对照组,差异有统计学意义(P <0.05);试验组的总有效率(93.5%)高于对照组(80.4%),差异有统计学意义(P <0.05);试验组的不良反应发生率(4.3%)低于对照组(13.0%),差异有统计学意义(P <0.05)。结论喜炎平联合阿米卡星雾化吸入治疗铜绿假单胞菌肺部感染疗效和安全性均较高,可明显改善患者的肺功能,降低病原微生物浓度,不良反应发生率低,值得临床推行。

Objective To analyze curative effects and safety of different administration methods of Xiyanping combined with amikacin in the treatment of pulmonary infection of pseudomonas aeruginosa. Methods 92 patients with pulmonary infection of pseudomonas aeruginosa who were admitted to our hospital from October 2017 to October 2018 were selected.They were divided into the experimental group and the control group,with 46 patients in each group.The experimental group was given atomized inhalation of 7.5 mg/kg amikacin dissolved into 20 mL sodium chloride solution with a concentration of 0.9%,2 times/d,20 min/time.The control group received amikacin 15 mg/(kg·d)intravenously,with no more than 1.5 g per day.Both groups were treated with Xiyanping for a total of 1 week,supplemented by expectorant removal,external drainage,correction of the imbalance of water,electrolyte,acid and base and nutritional support.The improvement of lung function,the concentration of pathogenic microorganisms(pseudomonas aeruginosa),the curative effect and the occurrence of adverse reactions in the two groups were compared. Results The FEV1 and DLCO levels in the experimental group were higher than those in the control group at 1 week and 6 months after treatment,and the difference was significant(P < 0.05).The concentrations of protomicrobs(pseudomonas aeruginosa)in the experimental group at 1 week and 6 months after treatment were lower than those in the control group,and the difference was significant(P < 0.05).The total effective rate of the experimental group(93.5%)was higher than that of the control group(80.4%),and the difference was significant(P<0.05).The incidence of adverse reactions in the experimental group(4.3%)was lower than that in the control group(13.0%),and the difference was significant(P < 0.05). Conclusion Atomization inhalation of Xiyanping combined with amikacin for the treatment of pulmonary infection of pseudomonas aeruginosa has higher curativeeffects and safety.It can significantly improve the lung function of patients,reduce the concentration of pathogenic microorganisms and reduce the incidence of adverse reactions,which is worthy of clinical application.