利奈唑胺联合手术治疗耐甲氧西林金黄色葡萄球菌感染的急性骨髓炎的临床效果观察  

Clinical observation on the combined surgical treatment of vancomycin and linezolid for acute osteomyelitis caused by methicillin-resistant Staphylococcus aureus

作　　者：王海峰 王文华 WANG Hai-feng;WANG Wen-hua(Department of Pediatric Surgery,Linyi Central Hospital,Linyi 276400,China)

机构地区：[1]临沂市中心医院小儿外科,276400

出　　处：《中国实用医药》2024年第17期14-18,共5页China Practical Medicine

摘　　要：目的对耐甲氧西林金黄色葡萄球菌感染的急性骨髓炎患儿使用利奈唑胺联合手术治疗的效果进行分析。方法42例耐甲氧西林金黄色葡萄球菌感染的急性骨髓炎患儿作为研究对象,按随机抽样法分为常规组和研究组,各21例。常规组患儿使用万古霉素联合手术治疗,研究组患儿使用利奈唑胺联合手术治疗。比较两组患儿的治疗效果、不良反应发生率、临床指标、炎症反应指标、肾功能指标。结果和常规组(66.67%)相比,研究组治疗总有效率(95.24%)更高(P<0.05)。研究组不良反应发生率为9.52%,低于常规组的38.10%(P<0.05)。研究组引流管置管时间、抗生素使用时间、住院时间分别为(12.01±2.40)、(24.36±5.28)、(27.24±4.31)d,均短于常规组的(14.98±2.44)、(36.87±7.43)、(36.38±6.23)d(P<0.05)。研究组治疗后白细胞计数、红细胞沉降率、超敏C反应蛋白水平分别为(5.64±1.42)×10^(9)/L、(27.50±4.54)mm/h、(14.15±2.76)mg/L,均低于常规组的(8.87±1.93)×10^(9)/L、(38.76±4.87)mm/h、(24.96±3.13)mg/L(P<0.05)。研究组治疗后尿素氮、血肌酐水平分别为(4.64±1.55)mmol/L、(79.26±11.40)μmol/L,均低于常规组的(7.78±2.79)mmol/L、(122.86±21.19)μmol/L(P<0.05)。结论为耐甲氧西林金黄色葡萄球菌感染的急性骨髓炎患儿使用利奈唑胺联合手术治疗疗效显著,可减轻患儿炎症反应,优化肾功能,且不良反应少,临床应用价值较高。Objective To analyze the effect of combined surgical treatment of vancomycin and linezolid for acute osteomyelitis caused by methicillin-resistant Staphylococcus aureus.Methods A total of 42 children with acute osteomyelitis caused by methicillin-resistant Staphylococcus aureus were selected as the study subjects.The children were randomly divided into a conventional group and a study group,each with 21 cases.The conventional group received vancomycin combined with surgery,while the study group received linezolid combined with surgery.The treatment effects,incidence of adverse reactions,clinical indicators,inflammation indicators,renal function indicators were compared between the two groups.Results Compared with the conventional group(66.67%),the total effective rate of the study group(95.24%)was higher(P<0.05).The incidence of adverse reactions in the study group was 9.52%,which was lower than 38.10%in the conventional group(P<0.05).The drainage tube insertion time,antibiotic use time and hospitalization time in the study group were(12.01±2.40),(24.36±5.28)and(27.24±4.31)d,which were shorter than(14.98±2.44),(36.87±7.43)and(36.38±6.23)d in the conventional group(P<0.05).After treatment,the white blood cell count,erythrocyte sedimentation rate and hypersensitive C-reactive protein levels in the study group were(5.64±1.42)×10^(9)/L,(27.50±4.54)mm/h and(14.15±2.76)mg/L,which were lower than(8.87±1.93)×10^(9)/L,(38.76±4.87)mm/h and(24.96±3.13)mg/L in the conventional group(P<0.05).After treatment,the levels of urea nitrogen and serum creatinine in the study group were(4.64±1.55)mmol/L and(79.26±11.40)μmol/L,which were lower than(7.78±2.79)mmol/L and(122.86±21.19)μmol/L in the conventional group(P<0.05).Conclusion The use of linezolid combined with surgery for the treatment of acute osteomyelitis caused by methicillin-resistant Staphylococcus aureus in children can reduce postoperative inflammation,improve renal function,reduce adverse reactions,and have significant therapeutic effects.The clinic

关 键 词：利奈唑胺 手术 耐甲氧西林金黄色葡萄球菌感染 急性骨髓炎 万古霉素 

分 类 号：R551.3[医药卫生—血液循环系统疾病]