头孢哌酮舒巴坦联合阿奇霉素治疗小儿大叶性肺炎的疗效观察

Clinical effect of cefoperazone and sulbactam combined with azithromycin on lobar pneumonia in children

目的观察头孢哌酮舒巴坦联合阿奇霉素对大叶性肺炎的治疗效果。方法采用前瞻性随机对照研究方法,将洛阳市东方人民医院2019年4月至2022年4月符合入选标准的大叶性肺炎患儿95例作为研究对象,按随机数字表法分为对照组(47例)和观察组(48例)。对照组接受常规治疗+阿奇霉素治疗,观察组接受头孢哌酮舒巴坦联合阿奇霉素治疗。比较两组治疗效果、症状体征消失时间(咳嗽咳痰消失时间、退热时间以及肺部体征消失时间)、血清炎症指标[高迁移率蛋白1(HMGB1)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]及不良反应。结果治疗2周期间,观察组剔除3例,对照组剔除2例;最后,对照组剩余45例,观察组剩余45例。治疗2周后,观察组总有效率(91.11%,41/45)高于对照组(75.56%,34/45),P<0.05;治疗期间,观察组咳嗽咳痰消失时间、退热时间、肺部体征消失时间均短于对照组(P均<0.05);治疗2周后,两组血清HMGB1、IL-6、CRP水平低于治疗前,且观察组低于对照组(P<0.05);观察组与对照组不良反应发生率比较差异未见统计学意义(P>0.05)。结论头孢哌酮舒巴坦联合阿奇霉素治疗小儿大叶性肺炎的效果显著,可缩短患儿症状体征消失时间,改善炎性指标。

Objective To observe the therapeutic effect of cefoperazone and sulbactam combined with azithromycin on lobar pneumonia in children.Methods A prospective randomized controlled study was conducted.A total of 95 children with lobar pneumonia who met the inclusion criteria treated in Luoyang Dongfang People’s Hospital from April 2019 to April 2022 were selected as research objects.And they were divided into control group(47 cases)and observation group(48 cases)according to random number table method.The control group received routine treatment combined with azithromycin,while the observation group received cefoperazone and sulbactam combined with azithromycin.The treatment effect,the time of disappearance of symptoms and signs(the time of disappearance of cough and sputum,the time of abatement of fever,and the time of disappearance of lung signs),serum inflammatory indexes including high mobility protein 1(HMGB1),interleukin-6(IL-6),C-reactive protein(CRP),and incidence of adverse reactions were compared between the two groups.Results During two weeks of treatment,3 cases were excluded from the observation group,and 2 cases were excluded from the control group.Finally,there were 45 cases in the control group and 45 cases in the observation group.After two weeks of treatment,the total effective rate of the observation group(91.11%,41/45)was higher than that of the control group(75.56%,34/45),P<0.05.During the treatment,the disappearance time of cough and expectoration,the time of abatement of fever,and disappearance time of lung signs in the observation group were shorter than those in the control group(all P<0.05).After two weeks of treatment,the levels of serum HMGB1,IL-6 and CRP in the two groups were lower than those before treatment,and the levels in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusions Cefoperazone and sulbactam combined with azithromycin is effective in the treatment of lobar pneumonia in children.It can shorten the time of disappearance of symptoms and signs,and improve the inflammatory indexes.