CAJ | 학술논문

目的：观察美罗培南、头孢哌酮／舒巴坦、米诺环素联合治疗泛耐药鲍曼不动杆菌性呼吸机相关肺炎的临床疗效。方法选择泛耐药鲍曼不动杆菌性呼吸机相关肺炎患者48例，应用5％葡萄糖（生理盐水）100 ml＋美罗培南2 g静脉滴注，1次／8 h，60 min滴入；5％葡萄糖（生理盐水）100 ml＋头孢哌酮／舒巴坦3 g静脉滴注，1次／8 h，60 min滴入；米诺环素0．1 g鼻饲，3次／d；联合治疗10～14 d。观察临床疗效、细菌清除率、肝肾功能、C反应蛋白、降钙素原、血常规和不良反应。结果联合抗菌治疗泛耐药鲍曼不动杆菌性呼吸机相关肺炎，临床治愈率62．50％，有效率75．00％，细菌清除率62．50％；对肝肾功能无明显影响，无明显不良反应。结论美罗培南、头孢哌酮／舒巴坦、米诺环素联合治疗泛耐药鲍曼不动杆菌性呼吸机相关肺炎效果较好。
목적：관찰미라배남、두포고동／서파탄、미낙배소연합치료범내약포만불동간균성호흡궤상관폐염적림상료효。방법선택범내약포만불동간균성호흡궤상관폐염환자48례，응용5％포도당（생리염수）100 ml＋미라배남2 g정맥적주，1차／8 h，60 min적입；5％포도당（생리염수）100 ml＋두포고동／서파탄3 g정맥적주，1차／8 h，60 min적입；미낙배소0．1 g비사，3차／d；연합치료10～14 d。관찰림상료효、세균청제솔、간신공능、C반응단백、강개소원、혈상규화불량반응。결과연합항균치료범내약포만불동간균성호흡궤상관폐염，림상치유솔62．50％，유효솔75．00％，세균청제솔62．50％；대간신공능무명현영향，무명현불량반응。결론미라배남、두포고동／서파탄、미낙배소연합치료범내약포만불동간균성호흡궤상관폐염효과교호。
Objective To observe the clinical effects of meropene and cefoperazone sulbactam associated with minocycline on the patients with ventilator-associated pneumonia caused by universal drug-resistant acinetobacter baumannii .Methods Forty-eight pa-tients with ventilator-associated pneumonia caused by PDRAB were respectively treated for a succession of 10 to 14 days with the follow-ing regimens:60-min intravenous infusion of 100 ml physiological saline +2 g meropene once every 8 hours;60-min intravenous infu-sion of 100 ml physiological saline +3 g cefoperazone sulbactam associated with minocycline also once every 8 hours;and 0.1g mino-cycline nasal gavage three times a day .Then, clinical therapeutic effects, bacterial clearance, hepatorenal function, C-reactive protein, calcitonin, blood routine and adverse drug reactions were observed closely .Results The clinical cure rate of combined drugs in the treatment of ventilator-associated pneumonia caused by universal drug-resistant acinetobacter baumannii was 62.50%, the effective rate was 75.00%, and the bacterial clearance rate was 62.50%, without obvious adverse drug reactions and effects on heptorenal function . Conclusion Combined treatment of meropene , cefoperazone sulbactam and minocycline could produce good effects on the patients with ventilator-associated pneumonia caused by universal drug-resistant acinetobacter baumannii .