多黏菌素B联合头孢哌酮钠舒巴坦钠对ICU多重耐药鲍曼不动杆菌致肺部感染的疗效分析

Efficacy of polymyxin B combined with cefoperazone sodium and sulbactam sodium in the treatment of pulmonary infection caused by multidrug resistant Acinetobacter baumannii in intensive care unit

目的探讨多黏菌素B联合头孢哌酮钠舒巴坦钠对重症监护室(ICU)多重耐药鲍曼不动杆菌(Ab)致肺部感染患者的疗效及对血清降钙素原(PCT)、C-反应蛋白(CRP)、白介素6(IL-6)水平的影响。方法选取2020年1月—2022年6月本院收治的80例ICU多重耐药Ab致肺部感染患者为研究对象,随机数字表法分为对照组、研究组各40例,对照组单纯静滴头孢哌酮钠舒巴坦钠治疗,研究组采用多黏菌素B联合头孢哌酮钠舒巴坦钠静滴治疗方案,均治疗2周。比较2组患者治疗效果、细菌学疗效,检测血清PCT、CRP、IL-6水平,记录ICU入住时间、住院费用和不良反应情况,统计院内死亡率。结果研究组总有效率(97.50%)高于对照组(80.00%),Ab清除率(95.00%)高于对照组(75.00%)(P<0.05)。与治疗前比较,2组治疗后血清PCT、CRP、IL-6水平均降低(P<0.05);与对照组比较,研究组治疗后血清PCT、CRP、IL-6水平较低(P<0.05)。研究组院内死亡率(2.50%)与对照组(7.50%)相比差异无统计学意义(P>0.05)。研究组ICU入住时间短于对照组,住院费用少于对照组(P<0.05)。2组均无中度、重度不良反应,且组间不良反应发生率比较差异无统计学意义(P>0.05)。结论多黏菌素B联合头孢哌酮钠舒巴坦钠对ICU多重耐药Ab致肺部感染的治疗效果显著,可有效清除细菌、减轻全身炎性反应,加速病情缓解,减轻患者经济负担,且安全可靠。

Objective This paper aims to investigate the efficacy of polymyxin B combined with cefoperazone sodium and sulbactam sodium in the treatment of pulmonary infection caused by multi-drug resistant Acinetobacter baumannii(Ab)in the intensive care unit(ICU)and the effects on the levels of serum procalcitonin(PCT),C-reactive protein(CRP)and interleukin-6(IL-6).Methods Eighty patients with lung infection caused by multi-drug resistant Ab in ICU admitted to our hospital from January 2020 to June 2022 were selected as the study objects.They were randomly divided into control group and study group with 40 patients in each group.The control group was treated with cefoperazone sodium and sulbactam sodium by intravenous drip only,and the study group was treated with polymyxin B combined with cefoperazone sodium and sulbactam sodium by intravenous drip for 2 weeks.The therapeutic effect and bacteriological effect of the two groups were compared,the levels of serum PCT,CRP and IL-6 were detected;the stay in ICU,hospitalization expenses and adverse reactions were recorded,and the hospital mortality was counted.Results The total effective rate in the study group(97.50%)was higher than that in the control group(80.00%),and the clearance rate of Ab was 95.00%,higher than 75.00%in the control group(P<0.05).Compared with before treatment,serum PCT,CRP and IL-6 in the two groups decreased on average after treatment(P<0.05).Compared with the control group,the levels of serum PCT,CRP and IL-6 in the study group were lower after treatment(P<0.05).The nosocomial mortality was 2.50%in the study group and 7.50%in the control group,with the difference statistically significant(P>0.05).The stay in ICU of the study group was shorter than that of the control group,and the hospitalization cost was lower than that in the control group(P<0.05).There was no moderate or severe adverse reactions in the two groups,and there was no statistical significance on the difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The therapeutic effect of polymyxin B combined with cefoperazone sodium and sulbactam sodium on pulmonary infection caused by multi drug resistant Ab in ICU is significant,which can effectively eliminate bacteria,reduce systemic inflammatory reaction,accelerate disease remission,and reduce patients’economic burden,which is safe and reliable.