铜绿假单胞菌注射液治疗深度烧伤脓毒症临床研究  

Clinical Study of Pseudomonas Aeruginosa Injection in the Treatment of Deep Burn Sepsis

作　　者：徐志刚 陈俏华 张栋梁 何亭 侯宏义 杨薛康 XU Zhigang;CHEN Qiaohua;ZHANG Dongliang;HE Ting;HOU Hongyi;YANG Xuekang(The First Affiliated Hospital of Air Force Medical University,Xi′an,Shaanxi,China 710032)

机构地区：[1]中国人民解放军空军军医大学第一附属医院,陕西西安710032

出　　处：《中国药业》2023年第14期99-103,共5页China Pharmaceuticals

基　　金：陕西省重点研发计划项目[2022SF-025]。

摘　　要：目的探讨铜绿假单胞菌(PA)注射液治疗深度(深Ⅱ度、Ⅲ度)烧伤脓毒症患者的临床疗效。方法前瞻性选取医院烧伤与皮肤外科2021年3月至2022年3月收治的深度(深Ⅱ度、Ⅲ度)烧伤脓毒症患者86例,按随机数字表法分为观察组和对照组,各43例。两组患者均于烧伤重症监护病房(BICU)接受监护治疗及常规治疗,观察组加予PA注射液皮下注射,两组患者均治疗2周且治疗后至少随访2周。结果观察组总有效率为93.02%,明显高于对照组的76.74%(P<0.05)。治疗后,两组患者T淋巴细胞CD4+水平均明显升高,CD8+水平均明显降低;中性粒细胞绝对计数(ANC)、白细胞计数及C反应蛋白、降钙素原水平均明显降低;且观察组改善幅度均明显大于对照组(P<0.05)。观察组BICU住院时间明显短于对照组,BICU住院费用明显少于对照组(P<0.05)。观察组与对照组并发症发生率相当(20.93%比32.56%,P>0.05);观察组中有3例患者用药局部出现轻度红肿,均自行消退,对照组患者未出现明显不良反应。结论PA注射液能促进深度烧伤脓毒症患者免疫功能提升,减轻炎症和感染,并缩短患者的住院时间,减少住院费用。Objective To investigate the clinical efficacy of Pseudomonas Aeruginosa(PA)Injection in the treatment of patients with deep burn(deep second or third degree burn)sepsis.Methods A total of 86 patients with deep burn(deep second or third degree burn)sepsis admitted to the Department of Burn and Skin Surgery in the hospital were selected prospectively and divided into the observation group and the control group by the random number table method,with 43 cases in each group.Patients in the two groups were given the care and routine treatment in the Burn Intensive Care Unit(BICU),on this basis,the patients in the observation group were given the subcutaneous injection of PA Injection.Both groups were treated for two weeks and followed up for at least two weeks after treatment.Results The total effective rate in the observation group was 93.02%,which was significantly higher than 76.74%in the control group(P<0.05).After treatment,the T lymphocyte CD4+level in the two groups increased significantly,while the CD8+level decreased significantly,the absolute neutrophil count(ANC),white blood cell count(WBC),C-reactive protein(CRP)and procalcitonin(PCT)levels decreased significantly,and the improvement of the above indexes in the observation group was more significant(P<0.05).The BICU stay in the observation group was significantly shorter than that in the control group,and the BICU cost in the observation group was significantly less than that in the control group(P<0.05).The incidence of complications in the observation group was similar to that in the control group(20.93%vs.32.56%,P>0.05).Three patients occured local and mild redness and swelling after medication in the observation group,all of which spontaneously subsided,while no patient occured obvious adverse reaction in the control group.Conclusion PA Injection can improve the immune function in patients with deep burn sepsis,alleviate inflammation and infection,shorten hospital stay,and reduce hospital costs.

关 键 词：深度烧伤 脓毒症 铜绿假单胞菌注射液 免疫功能 炎性反应 临床疗效 安全性 

分 类 号：R969.4[医药卫生—药理学] R644[医药卫生—药学]