ICU感染多重耐药铜绿假单胞菌肺炎的临床治疗  

Clinical experience of treatment of multiple drug resistant pseudomonas aeruginosa infectious pneumonia（MDRPAIP）

作　　者：胡光友[1] 葛香丽[1] 赵宝利[1] 王金磊[1] 

机构地区：[1]河南省济源市人民医院,454690

出　　处：《中国实用医刊》2014年第17期6-8,共3页Chinese Journal of Practical Medicine

摘　　要：目的：探讨头孢哌酮钠/舒巴坦联合阿米卡星及哌拉西林/他唑巴坦联合环丙沙星治疗ICU多重耐药铜绿假单胞菌肺炎的临床疗效及降钙素原（ PCT）对临床抗生素使用的指导意义。方法选取ICU确诊为多重耐药铜绿假单胞菌感染性肺炎患者50例，分为试验组（哌拉西林/他唑巴坦﹢环丙沙星）26例和对照组（头孢哌酮钠/舒巴坦﹢阿米卡星）24例，两组抗生素应用前PCT值基本相同，差异无统计学意义，观察相关临床指标。结果试验组有效率为88.5%，对照组有效率为87.5%，差异无统计学意义（ P﹥0.05）；两组患者在治疗2、7、14、21 d时的PCT均明显改善，试验组改善更明显（ P﹤0.05或P﹤0.01）；试验组咳嗽咳痰消失时间、白细胞恢复正常时间明显短于对照组，差异有统计学意义（P﹤0.01或P﹤0.05）。两组治疗后血压、脉搏、体温、呼吸比较差异无统计学意义（ P﹥0.05）。结论两种方式治疗ICU多重耐药铜绿假单胞菌肺炎均有效，哌拉西林/他唑巴坦联合环丙沙星的效果更明显，两种方法均值得在临床推广应用。Objective To investigate the clinical effects of cefoperazone/sulbactam combined with amikacin and piperacillin/tazobactam combined with ciprofloxacin on multiple drug resistant pseudo-monas aeruginosa infectious pneumonia（ MDRPAIP）and the guiding significance of PCI in clinical usage of antibiotics. Methods Fifty patients with MDRPAIP were chose and divided into experiment group （piperacillin and tazobactam combined with ciprofloxacin,26 cases）and control group（cefoperazone/sulbactam combined with amikacin,24 cases）. PCT values of the two groups were basically equal,there was no significant difference. The relevant clinical indicators were observed. Results The effective rate was 88. 5% in experiment group and 87. 5% in control group,there was no significant difference（ P﹥0. 05）;PCT values in both groups at 2nd,7th,14th and 21th day of treatment improved obviously,and those in experiment group improved more obviousely（ P﹤0. 05 ,P﹤0. 05 ,P﹤0. 01 ,P﹤0. 01 ）;The disappearance time of cough and phlegm and time of white blood cell recover to normal level in experi-ment group was obviously shorter than that in control group（ P﹤0. 01 ,P﹤0. 05 ）. There was no signifi-cant difference in blood pressure,pulse,temperature and respiratory rate between the two groups（ P﹥0. 05）. Conclusions Both therapies are effective on MDRPAIP,and the effect of piperacillin/tazobac-tam combined with ciprofloxacin is better. Both therapies are worthy to be popularized and applied in clinics.

关 键 词：铜绿假单胞菌 头孢哌酮钠 舒巴坦 阿米卡星 哌拉西林 他唑巴坦 环丙沙星 降钙素原 

分 类 号：R563.1[医药卫生—呼吸系统]