替加环素辅助治疗ICU患者多重耐药菌感染临床效果探讨  

Clinical effect of tigecycline adjuvant treatment for patients with multi drug resistant bacteria infection in ICU

作　　者：李卜武 朱宏[1] 罗文朝[1] 何国鑫[1] 赵展[1] 

机构地区：[1]瑞安市人民医院重症医学科,浙江瑞安325200

出　　处：《实用药物与临床》2015年第5期567-570,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨替加环素辅助治疗ICU患者多重耐药菌感染的临床效果及安全性。方法选取我院重症医学科2012年6月至2014年6月收治的多重耐药鲍曼不动杆菌感染患者140例,采用随机数字表法分为对照组和试验组,每组70例;其中对照组患者采用头孢哌酮-舒巴坦治疗。试验组患者则在此基础上加用替加环素治疗。比较两组患者临床疗效,症状体征和实验室指标恢复时间,细菌清除及不良反应发生情况等。结果对照组和试验组患者治疗总有效率分别为61.43%(43/70)、91.43%(64/70),试验组总有效率高于对照组,差异有统计学意义(P<0.05);对照组患者体温、肺部啰音、胸部X线平片、白细胞及CRP水平恢复正常时间分别为(5.25±1.78)d、(10.60±2.81)d、(16.28±5.52)d、(6.32±2.05)d、(11.32±3.63)d,试验组分别为(3.51±1.04)d、(7.47±2.20)d、(12.64±4.18)d、(3.75±1.14)d、(4.56±1.24)d,试验组均显著少于对照组,差异有统计学意义(P<0.05);对照组患者细菌清除率、细菌替换率及细菌再感染率分别为41.43%(29/70)、21.43%(15/70)、10.00%(7/70),试验组分别为64.29%(45/70)、8.57%(6/70)、1.43%(1/70),试验组患者细菌清除率高于对照组,细菌替换率和细菌再感染率低于对照组,差异有统计学意义(P<0.05);对照组和试验组患者不良反应总发生率分别为10.00%(7/70)、8.57%(6/70),两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论替加环素辅助治疗ICU患者多重耐药菌感染可有效改善症状体征,提高细菌清除效果,加快病情康复进程,且未增加不良反应发生风险,具有临床应用价值。Objective To investigate the clinical effect and safety of tigecycline adjuvant treatment for patients with multi-drug resistant bacteria infection in ICU. Methods 140 patients with multi-drug resistant bacteria infection in ICU were chose from June 2012 to June 2014 in our hospital and randomly divided into control group （ n=70 ） with cefoperazone-sulbactam treatment and experiment group （ n=70 ） with tigecycline on the basis of control group. The clinical efficacy,recovery time of symptoms,signs and level of laboratory indicators,the occurrence of bacterial clear-ance and adverse reactions of both groups were compared. Results The total effective rate of control group and experi-ment group were 61. 43%（43/70）and 91. 43%（64/70）,there was significant difference between the two groups（P〈0. 05）. The recovery time of body temperature,pulmonary rales,chest X-ray image,levels of white blood cells and CRP of control group were （5. 25 ±1. 78）d,（10. 60 ±2. 81）d,（16. 28 ±5. 52）d,（6. 32 ±2. 05）d,（11. 32 ±3. 63）d,those of experimental group were （3.51 ±1.04）d,（7.47 ±2.20）d,（12.64 ±4.18）d,（3.75 ±1.14）d,（4.56 ±1.24）d, experiment group were significantly shorter than those of control group（P〈0. 05）. The bacterial clearance rate,bacteria substitution rate and bacterial reinfection rate were 41. 43%（ 29/70 ） , 21. 43%（ 15/70 ） , 10. 00%（ 7/70 ） in control group and 64. 29%（45/70）,8. 57%（6/70）,1. 43%（1/70）in experiment group,there were significant differences be-tween the two groups （P〈0. 05）. The total incidence of adverse reactions of control group and experiment group were 10. 00%（7/70） and 8. 57%（6/70）,there was no significant difference between the two groups （P〉0. 05）. Conclu-sion Tigecycline adjuvant treatment for patients with multi drug resistant bacteria infection in ICU can efficiently re-lieve clinical symptoms and signs,enhance bacterial clearance effect,speed up recovery process with lower advers

关 键 词：替加环素 ICU多重耐药 感染 疗效 安全性 

分 类 号：R446.5[医药卫生—诊断学]