头孢哌酮/舒巴坦联合替加环素治疗广泛耐药鲍曼不动杆菌致呼吸机相关性肺炎的临床效果

Clinical effect of Cefoperazone/Sulbactam combined with Tigecycline in the treatment of ventilator-associated pneumonia caused by extensively drug-resistant Acinetobacter baumannii

目的观察头孢哌酮/舒巴坦联合替加环素治疗广泛耐药鲍曼不动杆菌(XDRAB)致呼吸机相关性肺炎(VAP)的临床效果作为研究对象。方法选取2021年6月至2022年6月上饶市广信区人民医院急诊ICU收治的68例XDRAB致VAP患者作为研究对象,采用随机数字表法分为对照组和观察组,各34例。对照组给予头孢哌酮/舒巴坦治疗,观察组在此基础上联合替加环素治疗。比较两组的临床治疗效果、微生物清除率、血清炎症因子水平变化及不良反应发生率。结果观察组治疗总有效率为97.06%,高于对照组的76.47%,差异有统计学意义(P<0.05);观察组细菌清除率为94.12%,高于对照组的58.82%,差异有统计学意义(P<0.05);治疗后,观察组肿瘤坏死因子-α、C反应蛋白低于对照组,白介素-10高于对照组,差异有统计学意义(P<0.05);两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论头孢哌酮/舒巴坦联合替加环素能够提高ICU中XDRAB致VAP患者细菌清除率,抑制全身炎症反应,具有较好的临床疗效,且安全性良好。

Objective To observe the clinical effect of Cefoperazone/Sulbactam combined with Tigecycline in the treatment of ventilator-associated pneumonia(VAP)caused by extensively drug-resistant Acinetobacter baumannii(XDRAB).Methods From June 2021 to June 2022,68 patients with VAP caused by XDRAB admitted to Department of Emergency,Guangxin District People's Hospital were selected as research objects and divided into control group and observation group according to the random number table method,with 34 cases in each group.The control group was treated with Cefoperazone/Sulbactam,and the observation group was treated with Tigecycline on this basis.The clinical treatment effect,microbial clearance rate,changes in serum inflammatory factors and incidence of adverse reaction were compared between the two groups.Results The total effective rate of the observation group was 97.06%,higher than that of the control group(76.47%),and the difference was statistically significant(P<0.05).The bacterial clearance rate in the observation group was 94.12%,higher than that in the control group(58.82%),and the difference was statistically significant(P<0.05).After treatment,tumor necrosis factor-αand C-reactive protein in observation group were lower than those of control group,and interleukin-10 was higher than that of control group,the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Cefoperazone/Sulbactam combined with Tigecycline in the treatment of XDRAB induced VAP can improve the bacterial clearance rate and inhibit the inflammatory response,with good clinical efficacy and safety.