CAJ | 학술논문

目的：探讨替加环素辅助治疗ICU患者多重耐药菌感染的临床效果及安全性。方法选取我院重症医学科2012年6月至2014年6月收治的多重耐药鲍曼不动杆菌感染患者140例,采用随机数字表法分为对照组和试验组,每组70例；其中对照组患者采用头孢哌酮-舒巴坦治疗。试验组患者则在此基础上加用替加环素治疗。比较两组患者临床疗效,症状体征和实验室指标恢复时间,细菌清除及不良反应发生情况等。结果对照组和试验组患者治疗总有效率分别为61．43%(43/70)、91．43%(64/70),试验组总有效率高于对照组,差异有统计学意义(P<0．05)；对照组患者体温、肺部啰音、胸部X线平片、白细胞及CRP水平恢复正常时间分别为(5．25±1．78)d、(10．60±2．81) d、(16．28±5．52) d、(6．32±2．05) d、(11．32±3．63) d,试验组分别为(3．51±1．04)d、(7．47±2．20)d、(12．64±4．18)d、(3．75±1．14)d、(4．56±1．24)d,试验组均显著少于对照组,差异有统计学意义(P<0．05)；对照组患者细菌清除率、细菌替换率及细菌再感染率分别为41．43%(29/70)、21．43%(15/70)、10．00%(7/70),试验组分别为64．29%(45/70)、8．57%(6/70)、1．43%(1/70),试验组患者细菌清除率高于对照组,细菌替换率和细菌再感染率低于对照组,差异有统计学意义( P<0．05)；对照组和试验组患者不良反应总发生率分别为10．00%(7/70)、8．57%(6/70),两组患者不良反应发生率比较差异无统计学意义(P>0．05)。结论替加环素辅助治疗ICU患者多重耐药菌感染可有效改善症状体征,提高细菌清除效果,加快病情康复进程,且未增加不良反应发生风险,具有临床应用价值。
목적：탐토체가배소보조치료ICU환자다중내약균감염적림상효과급안전성。방법선취아원중증의학과2012년6월지2014년6월수치적다중내약포만불동간균감염환자140례,채용수궤수자표법분위대조조화시험조,매조70례；기중대조조환자채용두포고동-서파탄치료。시험조환자칙재차기출상가용체가배소치료。비교량조환자림상료효,증상체정화실험실지표회복시간,세균청제급불량반응발생정황등。결과대조조화시험조환자치료총유효솔분별위61．43%(43/70)、91．43%(64/70),시험조총유효솔고우대조조,차이유통계학의의(P<0．05)；대조조환자체온、폐부라음、흉부X선평편、백세포급CRP수평회복정상시간분별위(5．25±1．78)d、(10．60±2．81) d、(16．28±5．52) d、(6．32±2．05) d、(11．32±3．63) d,시험조분별위(3．51±1．04)d、(7．47±2．20)d、(12．64±4．18)d、(3．75±1．14)d、(4．56±1．24)d,시험조균현저소우대조조,차이유통계학의의(P<0．05)；대조조환자세균청제솔、세균체환솔급세균재감염솔분별위41．43%(29/70)、21．43%(15/70)、10．00%(7/70),시험조분별위64．29%(45/70)、8．57%(6/70)、1．43%(1/70),시험조환자세균청제솔고우대조조,세균체환솔화세균재감염솔저우대조조,차이유통계학의의( P<0．05)；대조조화시험조환자불량반응총발생솔분별위10．00%(7/70)、8．57%(6/70),량조환자불량반응발생솔비교차이무통계학의의(P>0．05)。결론체가배소보조치료ICU환자다중내약균감염가유효개선증상체정,제고세균청제효과,가쾌병정강복진정,차미증가불량반응발생풍험,구유림상응용개치。
Objective To investigate the clinical effect and safety of tigecycline adjuvant treatment for patients with multi-drug resistant bacteria infection in ICU. Methods 140 patients with multi-drug resistant bacteria infection in ICU were chose from June 2012 to June 2014 in our hospital and randomly divided into control group ( n=70 ) with cefoperazone-sulbactam treatment and experiment group ( n=70 ) with tigecycline on the basis of control group. The clinical efficacy,recovery time of symptoms,signs and level of laboratory indicators,the occurrence of bacterial clear-ance and adverse reactions of both groups were compared. Results The total effective rate of control group and experi-ment group were 61. 43%(43/70)and 91. 43%(64/70),there was significant difference between the two groups(P<0. 05). The recovery time of body temperature,pulmonary rales,chest X-ray image,levels of white blood cells and CRP of control group were (5. 25 ±1. 78)d,(10. 60 ±2. 81)d,(16. 28 ±5. 52)d,(6. 32 ±2. 05)d,(11. 32 ±3. 63)d,those of experimental group were (3.51 ±1.04)d,(7.47 ±2.20)d,(12.64 ±4.18)d,(3.75 ±1.14)d,(4.56 ±1.24)d, experiment group were significantly shorter than those of control group(P<0. 05). The bacterial clearance rate,bacteria substitution rate and bacterial reinfection rate were 41. 43%( 29/70 ) , 21. 43%( 15/70 ) , 10. 00%( 7/70 ) in control group and 64. 29%(45/70),8. 57%(6/70),1. 43%(1/70)in experiment group,there were significant differences be-tween the two groups (P<0. 05). The total incidence of adverse reactions of control group and experiment group were 10. 00%(7/70) and 8. 57%(6/70),there was no significant difference between the two groups (P>0. 05). Conclu-sion Tigecycline adjuvant treatment for patients with multi drug resistant bacteria infection in ICU can efficiently re-lieve clinical symptoms and signs,enhance bacterial clearance effect,speed up recovery process with lower adverse re-actions risk.