摘要
目的探讨哌拉西林/他唑巴坦联合阿米卡星治疗支气管扩张合并下呼吸道感染的临床效果。方法选取支气管扩张合并下呼吸道感染患者86例,随机分成观察组和对照组各43例。在常规治疗基础上,观察组给予哌拉西林/他唑巴坦联合阿米卡星抗感染治疗,对照组给予哌拉西林/他唑巴坦抗感染治疗。比较两组治疗前后的临床效果、白细胞总数、C反应蛋白、降钙素原、痰细菌培养结果、第1秒用力呼气容积、改良英国医学研究委员会呼吸困难评分(score of dyspnea in the modified version of British Medical Research Council,mMRC)和6 min步行距离。结果观察组初期临床成功率高于对照组(P<0.05)。观察组治疗后3个月内再次下呼吸道感染率低于对照组(P<0.05),治疗后3个月肺功能较对照组差异无统计学意义,病原菌治疗成功率高于对照组(P<0.05),mMRC优于对照组(P<0.05),6 min步行距离远于对照组(P<0.001)。结论哌拉西林/他唑巴坦联合阿米卡星治疗支气管扩张合并下呼吸道感染,与哌拉西林/他唑巴坦单药相比具有较高的临床成功率、病原菌治疗成功率和较低的再感染率,能较好地改善临床症状,值得临床推广应用。
Objective To observe the clinical effect of piperacillin-tazobactam combined with amikacin in the treatment of bronchiectasis complicated with lower respiratory tract infection.Methods Eighty-six patients with bronchiectasis and lower respiratory tract infection were randomly divided into the observation group(n=43)and the control group(n=43).The observation group was treated with piperacillin-tazobactam combined with amikacin,while the control group was treated with piperacillin-tazobactam alone.The clinical effects,sputum bacterial culture results,forced expiratory volume in 1 second,score of dyspnea in the modified version of British Medical Research Council(mMRC)score and 6-minute walking distance of the two groups were compared after the treatment,as well as the total white blood cell count,C-reactive protein and procalcitonin before and after the treatment.Results The initial clinical success rate in the observation group was higher than that in the control group(P<0.05).The reinfection rate in the observation group was lower than that in the control group within 3 months post-treatment(P<0.05).and the success rate of pathogen treatment in the observation group was higher than that in the control group(P<0.05).There was no significant difference in pulmonary function between the two groups 3 months after the treatment,while the treatment success rate of pathogenic bacteria was higher than that of the control group(P<0.05).mMRC was better than that in the control group(P<0.05),and the 6-minute walk distance was farther than that in the control group(P<0.001).Conclusion Piperacillin-tazobactam combined with amikacin in the treatment of bronchiectasis with lower respiratory tract infection,compared with piperacillin-tazobactam monotherapy,has a higher clinical success rate,lower reinfection rate and better improvement of symptoms,so it is worthy of promotion and application.
作者
张学平
史秀华
赵娜
李新
ZHANG Xueping;SHI Xiuhua;ZHAO Na;LI Xin(Department of Respiratory Medicine,Binzhou Central Hospital,Binzhou 251700,Shandong,P.R.China)
出处
《滨州医学院学报》
2025年第4期393-396,401,共5页
Journal of Binzhou Medical University
