丙氨酰谷氨酰胺与注射用哌拉西林钠他唑巴坦钠联合疗法对胰腺癌术后腹腔感染患者的疗效

Efficacy of Alanyl Glutamine Combined with Piperacillin Tazobactam Sodium in the Treatment of Patients with Postoperative Abdominal Infection of Pancreatic Cancer

目的探讨丙氨酰谷氨酰胺联合注射用哌拉西林钠他唑巴坦钠治疗胰腺癌术后腹腔感染(IAI)患者的疗效。方法选取2013年1月至2020年1月于辽阳市中心医院治疗的胰腺癌术后IAI患者60例作为研究对象,根据治疗方案不同分为单药组(28例)与联合组(32例)。单药组予以注射用哌拉西林钠他唑巴坦钠治疗,联合组在单药组治疗基础上采用丙氨酰谷氨酰胺治疗。比较两组临床疗效、治疗前后血清炎症介质及不良反应发生情况,并采用Logistic分析法明确胰腺癌术后IAI患者疗效不良的影响因素。结果联合组治疗有效率略高于单药组,但差异无统计学意义(P>0.05)。治疗后7 d,联合组血清白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)低于单药组(P<0.05)。联合组与单药组恶心呕吐、腹泻以及皮疹发生率比较,差异无统计学意义(P>0.05)。Logistic分析发现,年龄和WBC、CRP、PCT水平以及不良反应是胰腺癌术后IAI患者疗效不良的独立危险因素。结论丙氨酰谷氨酰胺联合注射用哌拉西林钠他唑巴坦钠治疗胰腺癌术后IAI患者的疗效较佳,可有效降低血清炎症介质水平,不会增加不良反应发生风险。

Objective To explore the effect of alanyl glutamine combined piperacillin tazobactam sodium for postoperative abdominal infection(IAI) patients which had postoperative pancreatic cancer. Methods From January 2013 to January 2020, a total of 60 patients with IAI after pancreatic cancer treatment admitted to Department of General Surgery, Liaoyang Central Hospital were selected as the research objects. According to different treatment regiments, they were divided into single-drug group(28 cases) and combination group(32 cases). The single-drug group was treated with piperacillin sodium and tazobactam sodium for injection, and the combined group was treated with alanyl glutamine plus piperacillin sodium and tazobactam sodium for injection. Clinical efficacy, serum inflammatory mediators and adverse reactions before and after treatment were compared between the 2 groups, and the logistic analysis method was used to determine the factors affecting the poor efficacy of IAI patients after pancreatic cancer surgery. Results The treatment efficiency of the combined group was slightly higher than that of the single-agent group, but the difference was not statistically significant(P>0.05). 7 days after treatment, serum white blood cell count(WBC), C-reactive protein(CRP), and procalcitonin(PCT) in the combination group were lower than those in the single-drug group(P<0.05). There was no significant difference in the incidence of nausea, vomiting, diarrhea, and skin rash between the combination group and the single-drug group(P>0.05). Logistic analysis found that age, and the level of WBC, CRP, PCT levels and adverse reactions were independent risk factors for poor efficacy in IAI patients after pancreatic cancer surgery. Conclusion Alanyl glutamine combined with piperacillin tazobactam sodium has a better efficacy in the treatment of IAI patients with pancreatic cancer after surgery, and can effectively lower the level of serum inflammatory markers without increasing the risk of adverse reactions.