80例支气管扩张伴绿脓杆菌感染疗效分析

目的探讨头孢哌酮/舒巴坦联合雾化妥布霉素治疗支气管扩张伴绿脓杆菌感染的疗效观察。方法对入选的80例患者,随机分为观察组和对照组,观察组给予头孢哌酮/舒巴坦静脉输注及妥布霉素雾化吸入治疗,对照组将妥布霉素改为静脉输注,两组的疗效进行比较。结果两组患者有关病情恢复时间的相关指标、治疗前后肺功能指标及总有效率进行比较,差异有统计学意义(P0.05)。结论头孢哌酮/舒巴坦静脉输注联合妥布霉素雾化吸入治疗支气管扩张伴铜绿假单胞菌感染的疗效安全、可靠。     

不同药物雾化吸入辅助治疗肺部感染的临床效果研究

目的 探讨不同药物雾化吸入辅助治疗肺部感染的临床效果.方法 将140例肺部感染患者随机分为观察组70例和对照组70例,对照组采用传统的雾化液雾化吸入(庆大霉素 地塞米松 α-靡蛋白酶 氯化钠溶液),观察组采用妥布霉素雾化液雾化吸入(妥布霉素 地塞米松 α-靡蛋白酶 蒸馏水),均治疗7d后比较两组患者的治疗效果.结果 观察组与对照组的痰量、呼吸音、啰音、胸片、平均住院天数及雾化吸入时间等方面差异均有统计学意义(P＜0.01).结论 妥布霉素雾化吸入辅助治疗肺部感染的疗效好.     

两药联合治疗小儿支气管哮喘的临床效果观察

目的研究观察妥洛特罗贴剂与普米克令舒雾化吸入联合治疗小儿支气管哮喘的疗效。方法小儿支气管哮喘患者86例为临床研究对象。对照组使用普米克令舒雾化吸入治疗,实验组患者在对照组治疗基础上使用妥洛特罗贴剂治疗,对比观察两组治疗效果和安全性。结果实验组咳嗽、气喘、哮鸣音及湿啰音消失时间快,总有效率更高,与对照组患者比较差异明显(P0.05)。实验组患儿治疗后免疫指标及血常规均优于对照组患者(P0.05)。结论联合使用妥洛特罗贴剂与普米克令舒雾化吸入联合治疗小儿支气管哮喘疗效好。     

可必特+沐舒坦雾化吸入在支气管扩张并感染的临床观察

目的观察雾化吸入可必特(复方异丙托溴铵雾化溶液)联合沐舒坦在支气管扩张合并感染的临床疗效。方法我院呼吸科就诊的支气管扩张并感染患者60例,随机分为治疗组和对照组。对照组给予常规治疗,治疗组在此基础上给予雾化吸入可必特联合沐舒坦。观察两组临床疗效及治疗前后肺功能指标变化。结果治疗组的咳嗽,咳痰,发热症状减轻及湿性啰音范围固定的时间少于对照组,肺功能改善程度治疗组明显优于对照组。差异有显著性意义(P0.05)。结论雾化吸入可必特联合沐舒坦能减少支气管扩张合并感染患者的病程,对其咳嗽、咯痰、肺部湿啰音有明显的改善作用。     

头孢哌酮/舒巴坦与环丙沙星治疗老年支气管扩张急性加重患者临床比较

目的 评价头孢哌酮/舒巴坦与环丙沙星治疗老年支气管扩张急性加重患者的有效性和安全性.方法 入选90例老年支气管扩张急性加重患者,随机分为两组,每组45例,给予头孢哌酮/舒巴坦的为治疗组,给予环丙沙星的为对照组,观察两组药物治疗支气管扩张急性加重患者的疗效和安全性.结果 治疗组、对照组治疗支气管扩张急性加重患者的总有效率分别为93.3％和88.9％ （P＞0.05）,不良反应发生率为22.2％和24.4％ （P＞0.05）.两组患者痰液共分离细菌65株,治疗组、对照组细菌清除率分别为96.9％、75.0％、对铜绿假单胞菌的清除率分别为100％和81.3％,差异均有统计学意义（P＜0.05）.结论 头孢哌酮/舒巴坦与环丙沙星治疗老年支气管扩张急性加重患者疗效确切、不良反应发生率低,头孢哌酮/舒巴坦细菌清除率高于环丙沙星.     

阿奇霉素 头孢哌酮/舒巴坦联合小剂量地塞米松治疗大叶性肺炎的效果观察

目的观察采用阿奇霉素、头孢哌酮/舒巴坦联合小剂量地塞米松治疗大叶性肺炎的效果。方法选择大叶性肺炎患者172例,按照随机数字表法分为对照组和观察组各86例。对照组给予阿奇霉素联合小剂量地塞米松治疗,观察组给予阿奇霉素、头孢哌酮/舒巴坦联合小剂量地塞米松治疗,比较两组患者的临床疗效和不良反应的发生率。结果观察组疗效明显优于对照组(95.35%vs 86.05%,P0.05)。治疗过程中,过敏性皮疹、过敏性休克、寒颤、呼吸急促等不良反应发生率对照组为9.30%,观察组为16.28%,两组比较差异无统计学意义(P0.05)。结论采用阿奇霉素、头孢哌酮/舒巴坦联合小剂量地塞米松治疗大叶性肺炎患者临床效果较为显著,不良反应少,值得临床推广使用。     

阿奇霉素治疗支气管哮喘及对外周血T淋巴细胞功能的影响

目的探讨阿奇霉素治疗支气管哮喘的临床疗效及其对外周血辅助性T淋巴细胞功能的影响。方法 80例支气管哮喘患者随机分为观察组和对照组。对照组给予青霉素静注联合布地奈德、沙丁胺醇雾化吸入治疗,观察组给予阿奇霉素静注联合布地奈德、沙丁胺醇雾化吸入治疗,评价临床疗效。结果观察组总有效率显著高于对照组,P<0.01。治疗后,观察组IFN-γ、IL-4水平与治疗前及对照组比较有显著性差异(P<0.01)。结论阿奇霉素治疗支气管哮喘疗效确切,安全可靠。     

沙丁胺醇联合氨溴索雾化吸入治疗支气管扩张症的疗效观察

目的观察沙丁胺醇联合氨溴索雾化吸入治疗支气管扩张症的临床疗效。方法 65例支气管扩张症患者随机分成两组,对照组(n=33)采用对症支持及抗感染治疗,观察组(n=32)在对照组治疗基础上加用沙丁胺醇联合氨溴索雾化吸入治疗。观察和比较两组患者治疗前后临床症状和肺功能改善情况。结果观察组临床症状缓解时间较对照组明显缩短(P<0.05);两组患者治疗后较治疗前肺功能均明显改善,且观察组改善更为明显(P<0.05)。结论沙丁胺醇联合氨溴索雾化吸入治疗支气管扩张症疗效显著,能明显改善患者的临床症状及肺功能。     

支气管肺泡保留灌洗联合阿奇霉素序贯治疗在支气管扩张合并感染中的应用价值研究

目的观察支气管肺泡保留灌洗联合阿奇霉素序贯治疗在支气管扩张合并感染患者中的疗效。方法将40例支气管扩张合并感染的患者随机分为两组:对照组20例,采用常规治疗;治疗组20例,在联合阿奇霉素抗感染治疗基础上,给予支气管肺泡灌洗及出院后长期服用阿奇霉素治疗,观察两组患者的疗效。结果治疗组疗效明显优于对照组。结论支气管肺泡保留灌洗联合阿奇霉素序贯治疗支气管扩张合并感染的患者,具有疗效好、复发少、安全可靠的优点。     

头孢哌酮-舒巴坦联合阿奇霉素治疗社区获得性肺炎的临床观察

目的观察头孢哌酮-舒巴坦联合阿奇霉素治疗社区获得性肺炎(community-acquired pneumonia,CAP)的临床疗效和不良反应。方法将48例CAP患者,随机分为两组,治疗组为头孢哌酮-舒巴坦联合阿奇霉素组(n=24),对照组为单纯用头孢哌酮-舒巴坦(n=24),疗程均为7～14d,观察两组患者的临床疗效和不良反应。结果治疗组总有效率为95.83%,对照组的总有效率为83.33%,两组的临床疗效比较差异有统计学意义(P0.05)。治疗组不良反应发生率12.50%,对照组不良反应发生率8.33%,两组不良反应发生率比较差异无统计学意义(P0.05)。结论头孢哌酮-舒巴坦联合阿奇霉素治疗CAP可提高疗效,缩短病程,且耐受性良好。     

头孢哌酮/舒巴坦对老年医院获得性肺炎的疗效分析

目的 探讨头孢哌酮/舒巴坦对老年医院获得性肺炎(HAP)治疗效果.方法 对我院收治的98例老年医院获得性肺炎患者随机分为实验组及对照组,实验组患者用头孢哌酮/舒巴坦进行治疗,对照组患者采用头孢哌酮进行治疗,治疗后对两组患者疗效以及细菌清除率进行比较.结果 实验组患者的治疗效果以及致病菌的清除率明显优于对照组(P＜0.05).结论 头孢哌酮/舒巴坦对老年医院获得性肺炎具有良好的治疗效果,致病菌对其耐药性低.     

Case reports of the treatment with tobramycin solution for inhalation in severe bronchiectasis patients continuous infection of Pseudomonas aeruginosa]

Aerosolized tobramycin has been frequently used in cystic fibrosis patients in order to directly deliver the antibiotic to the endobronchial site of infection. Recently, we experienced three cases of severe chronic bronchial infection of Pseudomonas aeruginosa treated by aerosolized tobramycin inhalation (TOBI). For two cases, we succeeded in improving the patient's medical condition, quality of life, and reduced the amount of sputum. We consider that TOBI should be useful for chronic bronchial infection by Pseudomonas aeruginosa in the case of a patient who does not respond to usual antibiotics via other routes. But further investigation is necessary to reveal clinical efficacy and safety in non-CF patients with bronchiectasis.     

清开灵联合头孢哌酮钠/舒巴坦钠治疗老年肺气肿合并感染的疗效观察

目的观察清开灵联合头孢哌酮钠/舒巴坦钠治疗老年肺气肿合并感染的临床疗效。方法 58例老年肺气肿合并感染患者随机分为两组。治疗组33例和对照组30例。对照组(28例)予以头孢哌酮钠/舒巴坦钠治疗,治疗组(30例)在对照组基础上加用清开灵治疗。观察和比较两组临床疗效,症状缓解时间、体温恢复正常时间及住院时间。结果治疗组治疗总有效率为90.0%,对照组治疗总有效率为78.6%,两组比较有显著性差异(P<0.05);治疗组治疗后症状缓解时间、体温恢复正常时间及住院时间均明显优于对照组(P<0.05)。结论清开灵联合头孢哌酮钠/舒巴坦钠治疗老年肺气肿合并感染疗效显著,安全可靠,值得临床推广应用。     

丁胺卡那霉素联合头孢哌酮/舒巴坦治疗呼吸机相关肺炎的疗效

目的 探讨丁胺卡那霉素联合头孢哌酮/舒巴坦治疗VAP的有效性和安全性.方法 收集我科VAP病例62例,随机分成两组,治疗组32例和对照组30例,对照组（28例）予以头孢哌酮/舒巴坦治疗,治疗组（32例）予以丁胺卡那霉素联合头孢哌酮/舒巴坦治疗.观察和比较两组临床疗效、住院时间、不良反应和患者治疗前后血清CRP和PCT水平变化.结果 治疗组治疗总有效率为78.1%,对照组治疗总有效率为63.3%,两组比较有显著性差异（P〈0.05）;治疗组临床疗效、住院时间和患者治疗前后血清CRP和PCT水平变化等指标均明显优于对照组（P〈0.05）,有统计学意义.结论 丁胺卡那霉素联合头孢哌酮/舒巴坦治疗VAP,疗效显著、安全性高,且CRP和PCT下降显著,可作为治疗VAP的用药.     

铜绿假单胞菌注射液胸腔灌注治疗恶性胸腔积液的临床分析

目的观察铜绿假单胞菌注射液胸腔灌注治疗恶性胸腔积液的临床疗效及毒副反应。方法将70例晚期非小细胞肺癌伴恶性胸腔积液患者随机分为观察组和对照组,每组各35例。对照组在常规辅助治疗的基础上予以洛铂胸腔灌注治疗,观察组在对照组的基础上辅以铜绿假单胞菌注射液胸腔灌注,观察比较两组患者治疗后的临床疗效及毒副反应。结果治疗疗程结束后,多数患者胸腔积液情况得到了有效的控制,两组治疗的总有效率分别为77.1%和48.6%(P0.05)。两组患者治疗过程中的毒副反应主要以发热、胃肠道反应及骨髓抑制为主,两组比较差异无统计学意义(P0.05)。结论洛铂联合铜绿假单胞菌注射液比单独洛铂胸腔灌注治疗恶性胸腔积的疗效显著,毒副反应相当,可推荐临床应用。     

Addition of inhaled tobramycin to ciprofloxacin for acute exacerbations of Pseudomonas aeruginosa infection in adult bronchiectasis

RATIONALE: Pseudomonas aeruginosa lung infection in patients with bronchiectasis, a chronic airway disease that is characterized by episodes of exacerbation, is associated with more severe disease and a higher utilization of health-care resources. Inhaled tobramycin solution reduces the number of acute exacerbations in patients with cystic fibrosis (CF)-related bronchiectasis with P aeruginosa infection but remains untested in the treatment of exacerbations in patients with non-CF bronchiectasis. OBJECTIVES: This study tested the effect of adding inhaled tobramycin solution to oral ciprofloxacin (Cip) for the treatment of acute exacerbations of non-CF bronchiectasis in patients with P aeruginosa infection. METHODS: A double-blind, randomized, active comparator, parallel-design study conducted at 17 study centers (5 in the United Kingdom, and 12 in the United States) compared 2 weeks of therapy with Cip with either an inhaled tobramycin solution or placebo in 53 adults with known P aeruginosa infection who were having acute exacerbations of bronchiectasis. MEASUREMENTS: Clinical symptoms, pulmonary function, clinical efficacy, and sputum microbiology were investigated prospectively. Main results: An inhaled solution of Cip with tobramycin, compared to placebo, achieved greater microbiological response but no statistically significant difference in clinical efficacy at days 14 or 21. Clinical and microbiological outcomes at the test of cure (ie, the clinical outcome assessment at day 21) were concordant when an inhaled tobramycin solution was added to therapy with Cip and compared to placebo (p = 0.01). Both subject groups had similar overall adverse event rates, but subjects receiving therapy with an inhaled tobramycin solution reported an increased frequency of wheeze (50%; placebo group, 15%). CONCLUSIONS: The addition of an inhaled tobramycin solution to therapy with oral Cip for the treatment of acute exacerbations of bronchiectasis due to P aeruginosa improved microbiological outcome and was concordant with clinical outcome; the inability to demonstrate an additional clinical benefit may have been due to emergent wheeze resulting from treatment.     

Comparative clinical trial of cefoperazone versus ampicillin + tobramycin in severe bronchopulmonary and pleural infectious pathology

This study involved an open trial with parallel randomised series receiving either cefoperazone (2 g/d) or a combination of ampicillin (6 g/d) and tobramycin (3 to 4 mg/kg/d). The 30 patients included were of both sexes (male predominance), hospitalised, aged 62 +/- 11,5 years and suffering from a severe bronchopulmonary or pleural infection. Underlying pathology was serious (neoplasm, C.O.D.L., bronchiectasis, cardiac pathology). No significant difference was seen in the sampling of the two populations. Cefoperazone was prescribed in 2 infusions per 24 hours. Ampicillin was given as 3 infusions, followed by tobramycin administered by a similar number of injections. The duration of treatment was 16.8 +/- 9 days (cefoperazone) and 11,8 +/- 6,5 days (ampicillin + tobramycin). Overall evaluation (clinical, radiological and laboratory criteria) showed 88% (cefoperazone group) and 71% (ampicillin + tobramycin group) recovery and improvement rates. There were two failures in the cefoperazone group and 6 failures in the other group. These results were not statistically different. Three of the 6 failures could be attributed to resistance of the initial bacteria or selected by one or other type of treatment. None of the antibiotics prescribed raised any acceptability problems.