头孢哌酮钠舒巴坦钠不同给药方式治疗老年绿脓杆菌肺炎的疗效观察  

Efficacy of Cefoperazone sodium and sulbactam sodium in the treatment of senile Pseudomonas aeruginosa pneumonia

作　　者：隋东江 林乐拉 张晓艳 张丽娜 熊维维 刘小静 李海燕 黄相会 Sui Dongjiang;Lin Lela;Zhang Xiaoyan(Department of Respiratory and Critical Medical,Air Force Medical Center,PLA,Beijing 100142,China)

机构地区：[1]解放军空军特色医学中心呼吸与危重症医学科,北京100142

出　　处：《中华保健医学杂志》2021年第5期492-495,共4页Chinese Journal of Health Care and Medicine

摘　　要：目的观察头孢哌酮钠舒巴坦钠不同给药方式治疗老年绿脓杆菌肺炎的临床疗效。方法回顾性分析解放军空军特色医学中心2018年1月~2021年1月收治的绿脓杆菌肺炎老年患者资料98例,根据头孢哌酮钠舒巴坦钠给药方式,分为常规组(49例)和观察组(49例);常规组采用常规静脉滴注方式给药,观察组采用静脉微量泵泵注给药。对比两组临床疗效,感染控制情况指标:转阴时间、绿脓杆菌(PA)转阴率、复发率。观察治疗前后两组患者炎症反应指标:C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-8;实验室指标:降钙素原(PCT)、D-二聚体(D-D);免疫功能指标,T淋巴细胞亚群:CD3+、CD4+/CD8+、NK细胞占比的变化情况。结果观察组总有效率高于常规组,差异有统计学意义(P<0.05);两组治疗后PA转阴率差异无统计学意义(P>0.05),观察组转阴时间、治疗后3个月复发率均低于常规组,差异有统计学意义(P<0.05)。治疗前两组患者各项炎症反应指标、实验室指标与免疫功能指标差异均无统计学意义(P>0.05)。治疗后,两组患者炎性CRP、TNF-α、IL-6、IL-8表达水平均较本组治疗前降低,且观察组均低于常规组,差异有统计学意义(P<0.05);两组患者PCT、D-D均较本组治疗前降低,CD3+、CD4+/CD8+、NK细胞占比均较本组治疗前升高,差异有统计学意义(P<0.05);观察组实验室指标均低于常规组、免疫功能指标均高于常规组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论头孢哌酮钠舒巴坦钠持续静脉微量泵泵注给药方式治疗老年绿脓杆菌肺炎,能够获得更为良好的临床疗效,可进一步改善各项相关指标。Objective To observe the clinical efficacy of different administration of Cefoperazone sodium and sulbactam sodium in the treatment of elderly Pseudomonas aeruginosa pneumonia.Methods Data of elderly patients with Pseudomonas aeruginosa pneumonia admitted to Air Force Medical Center,PLA from January 2018 to January 2021 were retrospectively analyzed.According to the administration of Cefoperazone sodium and sulbactam sodium,49 cases were selected into the conventional group,and 49 cases were selected into the observation group.The conventional group was given conventional intravenous infusion,and the observation group was given intravenous micropump.Clinical efficacy and infection control indicators were compared between the two groups:negative time,PA negative conversion rate and recurrence rate;Observed two groups of patients before and after the treatment of inflammatory response index:c-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-8 and laboratory indexes,calcitonin original(PCT),D-dimer(D-D),and index of immune function:T lymphocyte subsets:CD3+,CD4+/CD8+and NK cell of changes.Results The clinical efficacy of observation group was better than conventional group,the difference was statistically significant(P<0.05).After 1 course of treatment,there was no statistical difference in PA negative conversion rate between the two groups(P<0.05).The time of negative conversion and recurrence rate 3 months after treatment in the observation group were lower than those in the conventional group,with statistical significance(P<0.05).Before treatment,there were no statistical differences in the inflammatory response indexes,laboratory indexes and immune function indexes between 2 groups(P>0.05).After treatment,the expression levels of inflammatory CRP,TNF-α,IL-6 and IL-8 in 2 groups were decreased compared with before treatment,the difference was statistically significant(P<0.05),the observation group was lower than the conventional group,the difference was statistically significant(P<0.05

关 键 词：细菌性肺炎 绿脓杆菌 头孢哌酮钠舒巴坦钠 静脉滴注 静脉泵注 

分 类 号：R563[医药卫生—呼吸系统]