摘要
本研究探讨多重耐药革兰阴性菌(MDR-GNB)感染卒中相关性难治肺炎患者应用多黏菌素E雾化吸入与头孢哌酮/舒巴坦联合治疗的临床效果。选取2022年1月至2024年12月医院收治的112例MDR-GNB感染卒中相关性难治肺炎患者,随机数字表法分为联合组(多黏菌素E雾化吸入联合头孢哌酮/舒巴坦治疗)、对照组(头孢哌酮/舒巴坦治疗),各56例。比较两组临床疗效、临床恢复情况、感染指标、美国国立卫生研究院卒中量表评分(NIHSS)、临床肺部感染评分(CPIS)变化及30 d内全因病死率。与对照组相比,联合组治疗后总有效率较高(P<0.05);经治疗联合组体温恢复、肺部阴影消失及入住ICU时间均短于对照组(P<0.05);治疗后联合组白细胞计数(WBC)、降钙素原(PCT)、C反应蛋白(CRP)水平均低于对照组(P<0.05);治疗后联合组CPIS、NIHSS评分均低于对照组(P<0.05);联合组30 d全因病死率低于对照组(P<0.05)。MDR-GNB感染卒中相关性难治肺炎患者在头孢哌酮/舒巴坦基础上联用多黏菌素E雾化吸入可提升治疗效果,促进恢复,减轻炎症水平,改善神经功能,降低病死率。
To investigate the clinical efficacy of aerosolized colistin combined with cefoperazone/sulbactam in the treatment of stroke-associated refractory pneumonia infected with multi-drug resistant gram-negative bacteria(MDR-GNB),this study selected 112 patients with MDR-GNB-infected stroke-associated refractory pneumonia admitted to the hospital from January 2022 to December 2024.Patients were divided into a combined group(atomized inhalation of polycolistin E combined with cefoperazone/sulbactam treatment)and a control group(cefoperazone/sulbactam treatment only)using random number table method,with 56 patients in each group.The clinical efficacy,clinical recovery,infection indicators,National Institutes of Health Stroke Scale(NIHSS)scores,clinical pulmonary infection score(CPIS)changes,and all-cause mortality within 30 days were compared between the two groups.Compared with the control group,the combined group had a higher total effective rate after treatment(P<0.05).After treatment,the body temperature recovery,lung shadow disappearance and ICU stay time of the combined group were shorter than those of the control group(P<0.05).After treatment,the white blood cell count(WBC),procalcitonin(PCT),and C-reactive protein(CRP)levels in the combined group were lower than those in the control group(P<0.05).After treatment,the CPIS and NIHSS scores in the combined group were lower than those in the control group(P<0.05).The 30-day all-cause mortality in the combined group was lower than that in the control group(P<0.05).In patients with MDR-GNB associated stroke-related refractory pneumonia,cefoperazone/sulbactam combined with polycolistin E atomized inhalation could improve the therapeutic efficacy,promote reocvery,reduce inflammation,improve neurological function,and reduce mortality.
作者
王加山
吕新龙
张政
WANG Jiashan;LVXinlong;ZHANG Zheng(Pharmacy Department of the 94th Hospital/the Tail,Lake Hospital of the Joint Service Support Force of the Chinese People's Liberation Army,Wuxi 320214,China)
出处
《药物生物技术》
2025年第5期638-642,共5页
Pharmaceutical Biotechnology
关键词
卒中相关性肺炎
多重耐药
革兰阴性菌感染
多黏菌素E
头孢哌酮/舒巴坦
疗效
Stroke-associated pneumonia
Multi-drug resistant
Gram-negative bacterial infection
Colistin
Cefoperazone/sulbactam
Efficacy
