替加环素在多重或泛耐药鲍曼不动杆菌引起的重症医院获得性肺炎治疗中的运用价值

目的 探讨替加环素在多重或泛耐药鲍曼不动杆菌引起的重症医院获得性肺炎治疗中的运用价值。 方法 将2014年7月-2015年12月绍兴市上虞人民医院收治的64例多重或泛耐药鲍曼不动杆菌引起的重症医院获得性肺炎患者分为2组,每组32例。对照组采用头孢哌酮/舒巴坦治疗。观察组在对照组基础上给予替加环素治疗。对比2组临床治疗效果、细菌清除情况、不良反应、病情及炎性指标变化。 结果 观察组疗效显著高于对照组,差异有统计学意义(Z=2.099,P<0.05);观察组细菌清除率(71.87%)、脱机成功率(62.50%)显著高于对照组(43.75%和34.37%),ICU住院时间显著低于对照组,差异有统计学意义(χ2=5.189、5.067,t=4.467,P<0.05);2组不良反应发生率对比差异无统计学意义(P>0.05);2组治疗后生理与慢性健康Ⅱ评分表(APACHE Ⅱ评分)、降钙素原(PCT)、C反应蛋白(CRP)显著降低(P<0.05);观察组治疗后APACHE Ⅱ评分、CRP、PCT显著低于对照组治疗后,差异有统计学意义(t=5.079、8.156、8.633,P<0.05)。 结论 替加环素治疗多重或泛耐药鲍曼不动杆菌引起的重症医院获得性肺炎疗效显著,具有较高的细菌清除率。 

The value of the application of tigecycline in the treatment of severe hospital acquired pneumonia caused by multiple or pan drug resistant Acinetobacter baumannii

Objective To explore the value of the application of tigecycline in the treatment of severe hospital acquired pneumonia caused by multiple or pan drug resistant Acinetobacter baumannii. Methods Sixty-four cases of severe hospital acquired pneumonia caused by multiple or pan drug resistant Acinetobacter baumannii were divided into two groups,32 cases in each group.The control group was used Cefoperazone/sulbactam in the treatment.Observation group was added tigecycline in the control group on the basis of the treatment.Compared with the two groups of clinical treatment effect,bacterial clearance,adverse reaction,disease and inflammatory index changes. Results The total effective rate of the observation group was significantly higher than that of the control group There was a significant difference (Z=2.099,P<0.05).The bacterial clearance rate (71.87%) and weaning success rate (62.50%) in the observation group were significantly higher than those in the control group (43.75% and 34.37%),and the hospitalization time of ICU was significantly lower than that of the control group.The difference was statistically significant (χ2=5.189,5.067,t=4.467,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).Ⅱ APACHE score,PCT,CRP were significantly decreased (P<0.05) after treatment in the two groups.After treatment APACHEⅡ score,PCT,CRP levels in the observation group were significantly lower than those in the control group after treatment.The difference was statistically significant (t=5.079,8.156,8.633,P<0.05). Conclusion The curative effect of the treatment of severe hospital acquired pneumonia caused by multiple or pan drug resistant Acinetobacter baumannii is significant,and the bacterial clearance rate is high.