头孢哌酮舒巴坦联合异帕米星治疗多重耐药鲍曼不动杆菌肺炎临床观察

Clinical Observation of Cefoperazone Sulbactam Combined with Isepamicin in the Treatment of Multiple-Drug Resistant Acinetobacter Baumannii Pneumonia

目的探讨头孢哌酮舒巴坦联合异帕米星治疗多重耐药鲍曼不动杆菌肺炎的临床疗效及对患者生活质量的影响。方法选取医院2018年3月至2019年3月收治的多重耐药鲍曼不动杆菌肺炎患者124例,按随机数字表法分为对照组和联合组,各62例。两组患者均予注射用头孢哌酮钠舒巴坦钠静脉滴注,联合组患者加用硫酸异帕米星注射液静脉滴注。两组患者均持续治疗14 d。结果联合组总有效率及细菌有效清除率分别为98.39%和95.16%,显著高于对照组的80.65%和72.58%(P<0.05);治疗后,联合组患者的白细胞恢复正常时间、肺部罗音消失时间、胸部X线摄片阴影消除时间、体温恢复正常时间均显著短于对照组,降钙素原(PCT)、C反应蛋白(CRP)、血清淀粉样蛋白A(SAA)和肿瘤坏死因子-α(TNF-α)水平均显著低于对照组,生活质量各维度评分均显著高于对照组(P<0.05);联合组与对照组的不良反应发生率相当(8.06%比6.45%,P>0.05)。结论头孢哌酮舒巴坦联合异帕米星治疗多重耐药鲍曼不动杆菌肺炎,可明显缩短临床表现改善时间,提高细菌清除率,降低炎性因子水平,改善患者的生活质量。

Objective To investigate the clinical efficacy of cefoperazone sulbactam combined with isepamicin in the treatment of patients with multiple-drug resistant Acinetobacter baumannii pneumonia and its effect on the quality of life of patients.Methods Totally 124 patients with multiple-drug resistant Acinetobacter baumannii pneumonia admitted to our hospital from March 2018 to March 2019 were selected and divided into the control group and the combined group according to the random number table method.The patients in the two groups were given intravenous drip with Cefoperazone Sodium and Sulbactam Sodium for Injection,on this basis,the patients in the combined group were given intravenous drip with Isepamicin Sulfate Injection.Both groups were continuously treated for 14 d.Results The total effective rate and effective bacterial clearance rate of the combined group were 98.39%and 95.16%,which were significantly higher than 80.65%and 72.58%of the control group(P<0.05).After treatment,the time of leukocyte recovery,lung rale disappearance,chest shadow elimination shown by X-ray and body temperature recovery in the combined group was significantly shorter than that in the control group(P<0.05).The levels of procalcitonin(PCT),C-reactive protein(CRP),serum amyloid A(SAA)and tumor necrosis factor-α(TNF-α)in the combined group were significantly lower than those in the control group,while the scores of quality of life in the combined group were significantly higher than those in the control group(P<005).The incidence of adverse reactions in the combined group was similar to that in the control group(8.06%vs.6.45%,P>0.05).Conclusion Cefoperazone sulbactam combined with isepamicin in the treatment of multiple-drug resistant Acinetobacter baumannii pneumonia can significantly shorten the improvement time of clinical manifestation,improve the bacterial clearance rate,reduce the levels of inflammatory factors,improve the quality of life of patients.