头孢哌酮钠舒巴坦钠联合美罗培南治疗危重症伴多重耐药革兰阴性菌感染患者的有效性及安全性

Clinical effect and safety of cefoperazone sodium and sulbactam sodium combined with meropenem in the treatment of critical illness complicated with multi-drug resistant Gram-negative bacteria infection

目的观察头孢哌酮钠舒巴坦钠联合美罗培南治疗危重症伴多重耐药革兰阴性菌感染患者的有效性及安全性。方法回顾性选取2019年1月—2021年3月福建医科大学附属漳州市医院收治的危重症伴多重耐药革兰阴性菌感染患者58例,根据治疗方法不同分为对照组和观察组,各29例。对照组采用头孢哌酮钠舒巴坦钠治疗,观察组在对照组基础上增加注射用美罗培南。2组均治疗1~2周。比较2组临床疗效、细菌清除率,治疗前及治疗72 h、1周、2周后血清肿瘤坏死因子α(TNF-α)、白介素6(IL-6)、降钙素原(PTC)、超敏C反应蛋白(hs-CRP)水平及白细胞计数(WBC)、中性粒细胞百分数(N%),不良反应发生情况。结果观察组治疗总有效率为93.10%,高于对照组的72.41%(χ^(2)=4.350,P=0.037)。治疗后观察组细菌清除率为93.10%,高于对照组的72.41%(χ^(2)=4.350,P=0037)。治疗72 h、1周、2周后,2组血清TNF-α、IL-6、PTC、hs-CRP水平及WBC、N%低于治疗前,且观察组低于对照组(P<0.05)。观察组不良反应总发生率为6.90%,低于对照组的27.89%(χ^(2)=4.350,P=0.037)。结论头孢哌酮钠舒巴坦钠联合美罗培南治疗危重症伴多重耐药革兰阴性菌感染患者的临床疗效确切,能够更有效地清除病原菌,减轻炎性反应,且安全性较高。

Objective To observe the clinical effect and safety of cefoperazone sodium and sulbactam sodium combined with meropenem in the treatment of critical illness complicated with multi-drug resistant Gram-negative bacteria infection.Methods A total of 58 cases of critical illness patients complicated with multi-drug resistant Gram-negative bacte-ria infection were selected in Zhangzhou Hospital Affiliated to Fujian Medical University from January 2019 to March 2021,and they were divided into control group and observation group,29 cases in each group.Patients in control group were given cefoperazone sodium and sulbactam sodium,and patients in observation group were given meropenem for injection.Both groups were treated for 1-2 weeks.Clinical effect,bacterial clearance rate,serum levels of TNF-α,IL-6,PTC,hs-CRP and WBC,N%before treatment and at 72 h,1 week,2 weeks after treatment,incidence of adverse reactions were compared between the two groups.Results Total effective rate of observation group was 93.10%,which was higher than 72.41%of control group(χ^(2)=4.350,P=0.037).Bacterial clearance rate after treatment of observation group was 93.10%,which was higher than 72.41%of control group(χ^(2)=4.350,P=0.037).At 72 h,1 week,2 weeks after treatment,serum levels of TNF-α,IL-6,PTC,hs-CRP and WBC,N%in the two groups were lower than those before treatment,and those in observa-tion group were lower than control group(P<0.05).Incidence of adverse reactions of observation group was 6.90%,which was lower than 27.89%of control group(χ^(2)=4.350,P=0.037).Conclusion Cefoperazone sodium and sulbactam sodium combined with meropenem have an exact clinical effect in the treatment of critical illness patients complicated with multi-drug resistant Gram-negative bacteria infection,which can more effectively clear bacteria,reduce inflammatory reaction,and with higher safety.