基于多准则决策的亚胺培南对头孢哌酮-舒巴坦治疗的重症感染患者风险-效益评价

Risk-benefit evaluation of imipenem in patients with severe infection treated with cefoperazone-sulbactam based on multi-criteria decision making

目的评价基于多准则决策对亚胺培南联合头孢哌酮-舒巴坦治疗重症感染患者的效益-风险。方法选取2020年3月—2022年5月收治于我院的98例重症肺部感染患者的临床资料,根据治疗方式的不同分为单一治疗组和联合治疗组,每组49例。单一治疗组单独使用头孢哌酮-舒巴坦治疗,联合治疗组采用头孢哌酮-舒巴坦联合亚胺培南的治疗。比较两组相关指标,建立亚胺培南联合头孢哌酮-舒巴坦治疗重症肺部感染患者的多准则决策模型,并对两组效益值、风险值及决策模型的稳定性进行评价。结果联合治疗组的控制感染时间、药物治疗时间、肺功能指标恢复时间、细菌学检查复常时间与单一治疗组相比显著缩短,不良反应总发生率显著降低(P<0.05);联合治疗组的总有效率、病原菌清除率显著高于单一治疗组(P<0.05);两组患者治疗前的肺功能指标、血常规指标以及炎症因子指标比较差异无统计学意义(P>0.05),治疗后两组均有明显改善且联合治疗组CRP、PLT改善程度显著高于单一治疗组(P<0.05);联合治疗组的效益值为78、风险值为72、总效益-风险值为75,而单一治疗组分别为60、56和58,联合治疗组的效益-风险100%高于单一治疗组,多准则决策模型的稳定性较好。结论对于重症肺部感染患者的治疗,头孢哌酮-舒巴坦联合亚胺培南的治疗效果更好,可明显改善肺功能和炎症因子的相关指标以及不良反应的发生,为临床提供了理论依据。

Objective In order to achieve better treatment effect,this paper evaluated the benefit-risk of imipenem combined with cefoperazone-sulbactam in the treatment of patients with severe infection based on multi-criteria decision making.Methods The clinical data of 96 patients with severe pulmonary infection admitted to our hospital from March 2020 to May 2022 were selected and divided into monotherapy group and combined treatment group according to different treatment methods,with 49 cases in each group.In the monotherapy group,cefoperazone-subactam was used alone,and the combined treatment group added the use of iminopenam on the basis of the treatment of the monotherapy group.Compared with the relevant indicators of the two groups,a multi-criteria decision-making model of imepepepepamine combined with cefoperazone-supadan was established for the treatment of patients with severe pulmonary infection,and the benefit value,risk value and the stability of the decision-making model of the two groups were evaluated.Results Compared with the control time of infection,drug treatment time,recovery time of lung function indicators and recurrence time of bacteriological examination in the combined treatment group,the monotherapy group were significantly shortened,and the total incidence of adverse reactions decreased significantly(P<0.05).The total efficiency and pathogen removal rate of the combined treatment group were significantly higher than that of the monotherapy group(P<0.05).There was no significant difference between the lung function index,blood routine index and inflammatory factor index of the two groups before treatment(P>0.05),but both groups improved significantly after treatment,and the improvement degree of CRP and PLT in the combined treatment group was significantly higher than that of the monotherapy group(P<0.05).The benefit value of the combined treatment group is 78,the risk value is 72,the total benefit-risk value is 75,while the monotherapy group is 60,56 and 58 respectively.The benefit-risk of the combined treatment group is better than that of the monotherapy group with 100%,and the stability of the multi-criterion decision-making model is better.Conclusion For the treatment of patients with severe pulmonary infection,compared with the use of cefoperazone-supadan alone,combined with imidepenam is more effective,which can significantly improve the relevant indicators of lung function and inflammatory factors,as well as the occurrence of adverse reactions,providing a theoretical basis for clinical practice.