哌拉西林／他唑巴坦治疗术后腹腔感染临床观察

目的探讨哌拉西林／他唑巴坦治疗术后腹腔感染的临床效果，为患者术后腹腔感染提供更好的治疗方法。方法选取新疆维吾尔自治区人民医院2010年12月～2012年12月收治的150例术后腹腔感染的患者进行研究。按照数字随机的方法将患者分为两组，每组75例。观察组采用哌拉西林／他唑巴坦治疗，静滴剂量为每次4．5g，q8h-q12h，疗程5～10d。对照组给予静脉滴注0．4g环丙沙星注射液＋0．5g甲硝唑注射液，1～2次／d，疗程5～14d，观察比较两组患者治疗后的疗效、细菌耐药情况以及患者的细菌清除率及住院时间。结果对照组术中留取标本耐药率为6．67％（5，75），观察组术中留取标本耐药率为22．67％（17/75）。除去耐药病例数，观察组总有效率[91．43％（64／70）]显著高于对照组[55．17％（32／58）]。观察组清除89株，清除率为84．8％，而对照组清除53株，清除率为49．1％，两组相比，差异有统计学意义（P〈0．05）。结论在复杂腹腔内感染的治疗中，哌拉西林／他唑巴坦作为经验性药物和确定性药物，单用的效果均明显优于环丙沙星联合甲硝唑，应作为腹腔内感染治疗的一线用药。

Clinical observation of Piperacillin/Tazobactam in the treatment of post-operative abdominal infection

Objective To study the efficacy of Piperacillin/Tazobactam on postoperative abdominal infection, and to provide a better way to treat postoperative abdominal infection. Methods 150 patients with postoperative abdorninal infection from De-cember 2010 to December 2012 in the People＇s Hospital of Xinjiang Uighur Autonomous Region were studied. They were di-vided into two groups. Each group had 75 cases. The observation group was treated with Piperacillin/Tazobactam, which was intravenous dosage of 4.5 g, qSh-q12h, 5-10 d. The control group was treated with Ciprofloxacin Injection 0.4 g＋0.5 g Metronidazole Injection intravenously, 1-2 times/d, for 5-14 d. After treatment, the efficacy and bacterial drug resistance; and the patient＇s bacterial clearance rate and hospitalization time comparisons would be observed. Results The drug resistance rates of control group and observation group were 6.67% （5/75） and 22.67% （17/75）. Except for the number of resistant cases, the total effective rate of observation group was 91.43% （64/70）, significantly higher than 55.17% （32/58） of control group. Observation group cleared away 89 plants, clearance rate was 84.8%, while the control group cleared away 53 plants, clear- ance rate was 49.1%. Compared to the two groups, the differences were significant （P 〈 0.05）. Conclusion Whether as a treatment of complicated intra-abdominal infections empirical drug, or certainty drugs, Piperacillin/Tazobactam alone is sig-nificantly better than the effect of Ciprofloxacin combined with Metronidazole, which should be treated as intra-abdominal in-fections first-line treatment.