血必净注射液辅助治疗多重耐药铜绿假单胞菌呼吸机相关性肺炎临床研究

Clinical Study on Xuebijing Injection in Adjuvant Therapy of Ventilator-Associated Pneumonia Due to Multidrug-Resistant Pseudomonas Aeruginosa

目的:观察血必净注射液辅助治疗多重耐药铜绿假单胞菌(MDR-PA)引起的呼吸机相关性肺炎(VAP)的临床疗效。方法:选取48例MDR-PA引起的VAP患者,按随机数字表法分为对照组和观察组各24例。对照组给予常规西药治疗,观察组在对照组基础上给予血必净注射液治疗。比较2组治疗前后急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)、临床肺部感染评分(CPIS)、机械通气时间、重症监护室(ICU)住院时间、气道峰压(PIP)、气道阻力(RAW)。结果:治疗前,2组APACHEⅡ评分、CPIS评分比较,差异无统计学意义(P>0.05)。治疗后,2组APACHEⅡ评分、CPIS评分较治疗前降低,且观察组APACHEⅡ评分、CPIS评分低于对照组,差异均有统计学意义(P<0.05)。观察组机械通气时间、ICU住院时间短于对照组(P<0.05)。观察组MDR-PA转阴率为54.2%,高于对照组25.0%,差异有统计学意义(P<0.05)。治疗前,2组PIP、RAW比较,差异无统计学意义(P>0.05)。治疗后,2组PIP、RAW低于治疗前,且观察组PIP、RAW低于对照组,差异有统计学意义(P<0.05)。结论:血必净注射液辅助治疗MDR-PA引起的VAP,可以改善患者肺部感染,提高呼吸功能,缩短机械通气以及ICU住院时间,提高细菌清除率。

Objective:To observe the clinical effect of Xuebijing injection in adjuvant therapy of ventilator-associated pneumonia(VAP)due to multidrug-resistant pseudomonas aeruginosa(MDR-PA).Methods:A total of 48 cases of patients with VAP due to MDR-PA were selected and divided into the control group and the observation group according to random number table method,with 24 cases in each group.The control group was treated with routine western medicine,and the observation group was additionally treated with Xuebijing injection based on the treatment of the control group.Scores of the Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ),Clinical Pulmonary Infection Score(CPIS),duration of mechanical ventilation,hospitalization time at Intensive care unit(ICU),peak inspiratory pressure(PIP)and airway resistance(RAW)before and after treatment in the two groups were compared.Results:Before treatment,there was no significant difference being found in the comparison of scores of APACHEⅡand CPIS between the two groups(P>0.05).After treatment,scores of APACHEⅡand CPIS in the two groups were decreased when compared with those before treatment,and the two scores in the observation group were lower than those in the control group,differences being significant(P<0.05).Duration of mechanical ventilation and hospitalization time at ICU in the observation group were shorter than those in the control group(P<0.05).Negative conversion rate of MDR-PA was 54.2%in the observation group,higher than that of 25.0%in the control group,the difference being significant(P<0.05).Before treatment,there was no significant difference being found in the comparison of PIP and RAW between the two groups(P>0.05).After treatment,PIP and RAW in the two groups were lower than those before treatment,and the two indexes in the observation group were lower than those in the control group,the difference being significant(P<0.05).Conclusion:In the adjuvant therapy of VAP due to MDR-PA,Xuebijing injection can improve pulmonary infection and respiratory function,shorten duration of mechanical ventilation and ICU hospitalization time,and enhance bacterial clearance rate.