头孢他啶阿维巴坦钠联合替加环素治疗ICU复杂性腹腔内感染的效果分析

Analysis of the Effect of Ceftazidime and Avibactam Sodium Combined with Tigecycline in the Treatment of Complicated Intra-Abdominal In⁃fection in ICU

目的分析ICU复杂性腹腔内感染采用头孢他啶阿维巴坦钠联合替加环素治疗的效果。方法方便选取2019年6月—2021年6月入住该院重症医学科的复杂性腹腔内感染患者85例,以简单随机化法分为两组,分别为常规组(42例)与联合组(43例)。常规组以头孢他啶阿维巴坦钠治疗,联合组在对照组基础上应用替加环素。比较两组临床有效率,治疗前后不同时间C反应蛋白(CRP)、降钙素原(PCT)水平,外周血CRP、PCT水平恢复正常时间、ICU居住时间、住院时间,不良反应发生情况。结果联合组的治疗有效率为93.02%,高于对照组的76.19%,差异有统计学意义(χ^(2)=4.647,P<0.05)。联合组治疗3 d的血清CRP、PCT水平分别为(32.01±5.87)mg/L、(5.07±2.00)ng/L,治疗结束时分别为(4.55±1.02)mg/L、(0.42±0.11)ng/L,常规组治疗3 d的血清CRP、PCT水平分别为(38.63±6.20)mg/L、(6.24±2.01)ng/L,治疗结束时分别为(5.02±1.23)mg/L、(0.42±0.11)ng/L,两组治疗3 d及治疗结束时的血清CRP、PCT水平均较治疗前降低,差异有统计学意义(P<0.05);联合组治疗3 d的血清CRP、PCT水平均低于常规组,差异有统计学意义(t=5.056、2.690,P<0.05)。联合组的外周血CRP、PCT水平恢复正常时间、ICU居住时间和住院时间均短于常规组,差异有统计学意义(t=5.509、7.208、2.205、2.361,P<0.05)。两组的不良反应发生率比较,差异无统计学意义(P>0.05)。结论ICU复杂性腹腔内感染采用头孢他啶阿维巴坦钠联合替加环素治疗能提高疗效,促进患者恢复,且不增加不良反应发生率,可在临床推广应用。

Objective To analyze the effect of ceftazidime and avibactam sodium combined with tigecycline in the treatment of complicated intra-abdominal infection in ICU.Methods A total of 85 patients with complicated intraabdominal infection who were admitted to the Department of Critical Care Medicine in the hospital from June 2019 to June 2021 were conveniently selected and divided into two groups by simple randomization,namely the conventional group(42 cases)and the combined group(43 cases).The routine group was treated with ceftazidime and avibactam sodium,and the combined group was treated with tigecycline on the basis of the control group.The clinical efficacy,C-reactive protein(CRP)and procalcitonin(PCT)levels at different times before and after treatment,the time for pe⁃ripheral blood CRP and PCT levels to return to normal,the ICU stay time,the length of hospital stay and the occur⁃rence of adverse reactions were compared between the two groups.Results The effective rate of the combined group was 93.02%,which was higher than that of the control group,76.19%,the difference was statistically significant(χ^(2)=4.647,P<0.05).The serum CRP and PCT levels of the combined group after 3 days of treatment were(32.01±5.87)mg/L and(5.07±2.00)ng/L,respectively,and at the end of treatment were(4.55±1.02)mg/L and(0.42±0.11)ng/L.The serum CRP and PCT levels of the routine group after 3 days of treatment were(38.63±6.20)mg/L,(6.24±2.01)ng/L,respectively,and at the end of treatment were(5.02±1.23)mg/L,(0.42±0.11)ng/L,the levels of serum CRP and PCT in the two groups after 3 days of treatment and at the end of treatment were lower than those before treatment,the difference was statistically significant(P<0.05).The serum CRP and PCT levels in the combination group were lower than those in the conventional group after 3 days of treatment,the difference was statistically significant(t=5.056,2.690,P<0.05).The recovery time of peripheral blood CRP and PCT levels,ICU stay time and hospitalization time in the combined group were shorter than those in the conventional group,the difference was statistically significant(t=5.509,7.208,2.205,2.361,P<0.05).There was no significant difference in the incidence of adverse reactions be⁃tween the two groups,the difference was not statistically significant(P>0.05).Conclusion Ceftazidime avibactam so⁃dium combined with tigecycline in the treatment of complicated intra-abdominal infection in ICU can improve the curative effect,promote the recovery of patients,and does not increase the incidence of adverse reactions,which can be popularized and applied in clinical practice.