【摘要】：目的:觀察替加環(huán)素聯(lián)合異帕米星治療多重耐藥鮑曼不動桿菌肺炎的臨床療效及安全性。方法:選取被診斷為多重耐藥鮑曼不動桿菌肺炎的患者70例,按隨機數(shù)字表法分為對照組和觀察組,各35例。兩組患者均給予氧療或機械通氣、降壓、控制血糖等常規(guī)治療。對照組患者給予注射用頭孢哌酮鈉舒巴坦鈉3 g加入氯化鈉注射液100 ml中,ivgtt,qid;觀察組患者給予注射用替加環(huán)素首次劑量100 mg,然后減至50 mg加入氯化鈉注射液250 ml中,ivgtt,bid,聯(lián)合硫酸異帕米星注射液400 mg加入氯化鈉注射液250 ml中,ivgtt,qd。觀察兩組患者體溫恢復正常、肺部Up音消失、胸片陰影消失、白細胞恢復正常時間及治療前后血清炎性因子水平,并比較兩組患者臨床療效、細菌學療效及不良反應(yīng)發(fā)生情況。結(jié)果:觀察組患者體溫恢復正常、肺部Up音消失、胸片陰影消失、白細胞恢復正常時間明顯短于對照組,差異有統(tǒng)計學意義(P0.05)。治療前,兩組患者血清炎性因子水平比較,差異無統(tǒng)計學意義(P0.05);治療后,兩組患者血清炎性因子水平顯著降低,且觀察組明顯低于對照組,差異均有統(tǒng)計學意義(P0.05)。觀察組患者臨床總有效率和有效細菌清除率(85.7%和82.9%)顯著高于對照組(62.9%和60.0%),差異均有統(tǒng)計學意義(P0.05)。兩組患者不良反應(yīng)發(fā)生率比較,差異無統(tǒng)計學意義(P0.05)。結(jié)論:替加環(huán)素聯(lián)合異帕米星治療多重耐藥鮑曼不動桿菌肺炎療效顯著,能明顯改善患者臨床癥狀,控制炎癥反應(yīng),殺菌作用明顯,且安全性較高。
[Abstract]:Objective: to observe the efficacy and safety of tigicycline combined with isopamicin in the treatment of multiple drug resistant Acinetobacter baumannii pneumonia. Methods: seventy patients diagnosed as multidrug resistant Acinetobacter baumannii pneumonia were randomly divided into control group (n = 35) and observation group (n = 35). Both groups were given oxygen therapy or mechanical ventilation, hypotension, control of blood sugar and other routine treatment. The patients in the control group were given cefoperazone sodium sulbactam 3 g for injection and sodium chloride injection 100ml, and the patients in the observation group were given the first dose of tegacycline 100 mg for injection, then reduced to 50 mg and added to 250ml sodium chloride injection In combination with isopamicin sulfate 400 mg / ml sodium chloride injection 250ml iv gttt QD. The temperature of the two groups returned to normal, the pulmonary up sound disappeared, the shadow of chest film disappeared, the white blood cell returned to normal time and the level of serum inflammatory factors before and after treatment were observed. The clinical efficacy, bacteriological effect and adverse reaction were compared. Results: in the observation group, the temperature returned to normal, the pulmonary up sound disappeared, the chest film shadow disappeared, and the white blood cell returned to normal time was significantly shorter than that in the control group (P0.05). Before treatment, there was no significant difference in serum inflammatory factors between the two groups (P0.05); after treatment, the levels of serum inflammatory factors in the two groups decreased significantly, and the observation group was significantly lower than the control group, the difference was statistically significant (P0.05). The total clinical effective rate and effective bacterial clearance rate (85.7% and 82.9%) in the observation group were significantly higher than those in the control group (62.9% and 60.0%), and the difference was statistically significant (P0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P0.05). Conclusion: the efficacy of tegicycline combined with isopamicin in the treatment of Acinetobacter baumannii pneumonia with multiple drug resistance is significant. It can significantly improve the clinical symptoms, control inflammatory reaction, have obvious bactericidal effect, and have a high safety in the treatment of Acinetobacter baumannii pneumonia.
【作者單位】： 開縣人民醫(yī)院呼吸內(nèi)科;開縣人民醫(yī)院感染管理科;
【分類號】：R563.1

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