脊柱术后肺部感染常见病原菌及头孢呋辛的治疗效果

Distribution of common pathogens isolated from spinal surgery patients with postoperative pulmonary infection and therapeutic effect of cefuroxime

目的分析脊柱术后肺部感染的常见病原菌分布情况,并探究头孢呋辛的治疗效果。方法选取2018年4月-2023年4月南阳医学高等专科学校第一附属医院收治的脊柱术后肺部感染患者80例为研究对象,分析其病原菌分布情况,随机分组法分为对照组和研究组,术后在相继出现咳嗽、咳痰、发热、气短、胸闷等症状后,予以化痰、营养支持、解痉平喘等常规治疗方法,对照组患者在此基础上予以注射用美洛西林钠静脉滴注,研究组在上述基础上取注射用头孢呋辛钠静脉滴注,评价治疗7 d后两组的治疗效果。结果80例脊柱术后肺部感染患者检出病原菌124株,其中革兰阴性菌85株,占比68.55%;治疗7 d后,研究组血清白细胞介素-6(IL-6)、降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)水平均低于对照组(P<0.05),肺功能用力肺活量(FVC)、呼气峰值流速(PEF)、第一秒用力呼气容积(FEV_(1))均高于对照组(P<0.05),研究组生活质量测定量表(WHOQOL-BREF)评分高于对照组(P<0.05),临床肺部感染评分(CPIS)低于对照组(P<0.05);治疗期间,两组患者均未出现明显的不良反应。结论脊柱术后肺部感染患者的病原菌以革兰阴性菌为主,临床可针对此类病原菌采取针对性抗菌治疗;头孢呋辛对脊柱术后肺部感染患者的治疗效果显著,可减轻患者的肺部感染情况,改善患者的病情,提升其肺功能及生活质量。

OBJECTIVE To investigate the distribution of common pathogens isolated from the spinal surgery patients with postoperative pulmonary infection and observe the therapeutic effect of cefuroxime.METHODS A total of 80 patients who underwent spinal surgery and had postoperative pulmonary infection in the First Affiliated Hospital of Nanyang Medical College from Apr 2018 to Apr 2023 were recruited as the research subjects.The distribution of pathogens was observed,the enrolled patients were randomly divided into the control group and the study group.The conventional therapies such as reducing phlegm,nutritional support and spasmolysis for asthma relief were carried out after the symptoms like cough,expectoration,fever,shortness of breath and chest tight occurred successively.The control group was given intravenous drip of mezlocillin sodium injection on basis of the above therapies,while the study group was given intravenous drip of cefuroxime injection.The therapeutic effects were evaluated and compared between the two groups after the treatment for 7 days.RESULTS Totally 124 strains of pathogens were isolated from the 80 spinal surgery patients with postoperative pulmonary infection,85(68.55%)of which were gram-negative bacteria.The levels of interleukin-6(IL-6),procalcitonin(PCT)and high sensitivity C-reactive protein(hs-CRP)of the study group were lower than those of the control group after the treatment for 7 days(P<0.05);the lung function indexes forced vital capacity(FVC),peak expiratory flow(PEF)and forced expiratory volume in one second(FEV_(1))of the study group were higher than those of the control group(P<0.05);the score of WHOQOL-BREF scale of the study group were higher than that of the control group(P<0.05);the clinical pulmonary infection score(CPIS)of the study group was lower than that of the control group(P<0.05).The two groups of patients did not have significant adverse reactions during the treatment.CONCLUSION The gram-negative bacteria are dominant among the pathogens isolated from the spinal surgery patients with postoperative pulmonary infection.It is necessary for the hospital to take targeted antibacterial therapies against the pathogens.Cefuroxime can achieve remarkable effect on treatment of the spinal surgery patients with postoperative pulmonary infection,alleviate the pulmonary infection,improve the illness condition and boost the lung function and quality of life.