多黏菌素E雾化吸入联合头孢哌酮钠舒巴坦钠治疗多重耐药革兰阴性菌感染所致肺炎患者的效果

Effects of Polymyxin E aerosol inhalation combined with Cefoperazone sodium and Sulbactam sodium in treatment of patients with pneumonia caused by multidrugresistant gram-negative bacteria infection

目的:观察多黏菌素E雾化吸入联合头孢哌酮钠舒巴坦钠治疗多重耐药革兰阴性菌感染所致肺炎患者的效果。方法:回顾性分析2021年5月至2023年10月该院收治的96例多重耐药革兰阴性菌感染所致肺炎患者的临床资料,依据治疗方案不同将其分为研究组与对照组各48例。对照组采用头孢哌酮钠舒巴坦钠治疗,研究组在对照组基础上采用多黏菌素E雾化吸入治疗。比较两组临床疗效、临床症状(肺部阴影消失、细菌清除、体温复常)改善时间,治疗前后血气分析指标[动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、血清炎性指标[降钙素原(PCT)、白细胞介素-6(IL-6)、T细胞免疫球蛋白黏蛋白-4(TIM-4)、C反应蛋白(CRP)]水平,以及不良反应发生率。结果:研究组治疗总有效率为93.75%,高于对照组的79.17%,差异有统计学意义(P<0.05);研究组肺部阴影消失时间、细菌清除时间、体温复常时间均短于对照组,差异有统计学意义(P<0.05);两组PaO_(2)、SaO_(2)水平均高于治疗前,且研究组高于对照组,两组PaCO_(2)水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组PCT、IL-6、TIM-4、CRP水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组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E雾化吸入联合头孢哌酮钠舒巴坦钠治疗多重耐药革兰阴性菌感染所致肺炎患者可提高治疗总有效率,缩短临床症状改善时间,改善血气分析指标水平,以及降低血清炎性指标水平的效果优于单纯头孢哌酮钠舒巴坦钠治疗。

Objective:To observe effects of Polymyxin E aerosol inhalation combined with Cefoperazone sodium and Sulbactam sodium in treatment of patients with pneumonia caused by multidrug-resistant gram-negative bacteria infection.Methods:The clinical data of 96 patients with pneumonia caused by multidrug-resistant gram-negative bacteria infection admitted to this hospital from May 2021 to October 2023 were retrospectively analyzed.According to different treatment options,they were divided into study group and control group,48 cases in each group.The control group was treated with Cefoperazone sodium and Sulbactam sodium,while the study group was treated with Polymyxin E aerosol inhalation on the basis of that of the control group.The clinical efficacy,the improvement time of clinical symptoms(disappearance of lung shadow,bacterial clearance,and recovery of body temperature),the blood gas analysis indexes[arterial partial pressure of oxygen(PaO_(2)),arterial oxygen saturation(SaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))]levels and the serum inflammatory indexes[procalcitonin(PCT),interleukin-6(IL-6),T cell immunoglobulin mucin-4(TIM-4),C-reactive protein(CRP)]levels before and after the treatment,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of treatment in the study group was 93.75%,which was higher than 79.17%in the control group,and the difference was statistically significant(P<0.05).The disappearance time of lung shadow,the bacterial clearance time and the body temperature recovery time in the study group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The levels of PaO_(2)and SaO_(2)in the two groups were higher than those before the treatment,and those in the study group were higher than those in the control group;the levels of PaCO_(2)in the two groups were lower than those before the treatment,and that in the study group was lower than that in the control group;and the differences were statistically significant(P<0.05).The levels of PCT,IL-6,TIM-4 and CRP in the two groups were lower than those before treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Polymyxin E aerosol inhalation combined with Cefoperazone sodium and Sulbactam sodium in the treatment of pneumonia caused by multidrug-resistant gram-negative bacteria infection can improve the total effective rate of treatment,shorten the time of clinical symptom improvement,improve the levels of blood gas analysis indexes,and reduce the levels of serum inflammatory factor indexes.Moreover,it is superior to simple Cefoperazone sodium and Sulbactam sodium treatment.