头孢哌酮/舒巴坦联合痰热清注射液对老年患者院内铜绿假单胞菌肺炎的疗效

Efficacy of Cefoperazone/Sulbactam combined with Tanreqing injection inelderly patients with nosocomial Pseudomonas aeruginosa pneumonia

摘要:

目的 探究头孢哌酮/舒巴坦联合痰热清注射液对老年患者院内铜绿假单胞菌(PA)肺炎的疗效。方法 选取武警河南总队医院内二科2016年6月1日至2020年11月30日入院48h后发生院内肺部感染的PA肺炎患者80例。依据给药方式不同分为舒普深组(头孢哌酮/舒巴坦)25例,痰热清注射液组20例,痰热清注射液+舒普深组35例。对比3组患者临床疗效、患者发热程度、痰液分泌量、中性粒细胞(NE)、白细胞(WBC)、降钙素原(PCT)、C-反应蛋白(CRP)及白细胞介素-6(IL-6)水平的差异。采用SPSS 20.0软件进行数据分析。根据数据类型,组间比较分别采用χ²检验或t检验。结果 80例临床肺炎患者痰液标本鉴定为PA的有效性为95.00%(285/300),PA体外培养药敏实验结果为选用头孢哌酮舒巴坦最合理。舒普深组的治疗有效率92.00%(23/25),高于痰热清注射液组85.00%(17/20),低于痰热清注射液+舒普深组97.20%(34/35),差异均有统计学意义(均P<0.05)。舒普深组体温回归正常范围患者比例80.00%(20/25),高于痰热清注射液组70.00%(14/20),低于痰热清注射液+舒普深组91.43%(32/35)；舒普深组痰液分泌量<50ml患者比例84.00%(21/25),高于痰热清注射液组75.00%(15/20),低于痰热清注射液+舒普深组85.71%(30/35),差异均有统计学意义(均P<0.05)。舒普深组NE、WBC、PCT、CRP及IL-6均显著低于痰热清注射液组,差异均有统计学意义(均P<0.05)；痰热清注射液联合舒普深组NE、WBC、PCT、CRP及IL-6水平低于舒普深组,差异均有统计学意义(均P<0.05)。结论 痰热清注射液联合头孢哌酮/舒巴坦可有效缓解PA所致的肺部炎症感染,具有显著的临床应用价值。

Abstract:

Objective To explore the efficacy of Cefoperazone/Sulbactam combined with Tanreqing injection in the elderly patients with the nosocomial Pseudomonas aeruginosa (PA) pneumonia. Methods A total of 80 elderly patients were selected for the study, who developed PA pneumonia after 48 hours of hospitalization in the Second Department of Internal Medicine, Henan Provincial Armed Police Corps Hospital from June 1,2016 to November 30,2020. They were divided into Supushen group (cefoperazone/sulbactam, n=25), Tanreqing group (n=20), and Tanreqing + Shupushen group (n=35). The three groups were compared in the clinical efficacy, fever degree, sputum secretion, neutrophils (NE), white blood cells (WBC), procalcitonin (PCT), C-reactive protein (CRP) and interleukin-6 ( IL-6) level. SPSS statistics 20.0 was used for statistical analysis. Depending on date type, comparison between the groups was performed using χ² test or t test. Results PA was identified in 95.00% (285/300) of the sputum specimens obtained in the 80 patients, and in vitro drug sensitivity test showed that the selection of cefoperazone and sulbactam was the most reasonable. The effectiveness in the Shupushen group was 92.00% (23/25), significantly higher than 85.00% (17/20) in the Tanreqing group but lower than 97.20% (34/35) in the Tanreqing + Shupushen group, the difference being statistically significant (all P<0.05). The number of patients with body temperature recovery in the Shupushen group (80.00%, 20/25) was higher than that in the Tanreqing group (70.00%, 14/20) but lower than that in the Tanreqing + Shupushen group (91.43%, 32/35); the number of the patients with sputum secretion <50 ml in the Shupushen group (84.00%, 21/25) was higher than that in the Tanreqing group (75.00%, 15/20) but lower than that in the Tanreqing + Shupushen group (85.71%, 30/35), the differences being statistically significant (all P<0.05). NE, WBC, PCT, CRP and IL-6 in the Tanreqing group was significantly higher than those in the Shupushen group but significantly lower than those in the Shupushen group (all P<0.05). Conclusion Tanreqing injection combined with cefoperazone/sulbactam can effectively relieve pulmonary inflammation and infection caused by PA and is significant in clinical application.