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目的观察比较替加环素联合亚胺培南/西司他丁、亚胺培南/西司他丁联合头孢哌酮舒巴坦、延长亚胺培南/西司他丁静脉滴注时间联合头孢哌酮舒巴坦对重症泛耐药鲍曼不动杆菌疗效的影响。方法选取重症医学科重症泛耐药鲍曼不动杆菌肺部感染患者36例,随机分为试验1、2、3组,每组12例,分别给予替加环素联合亚胺培南/西司他丁、亚胺培南/西司他丁联合头孢哌酮舒巴坦、延长亚胺培南/西司他丁静脉滴注时间联合头孢哌酮舒巴坦治疗,比较3组的临床疗效、细菌学疗效、试验室数据、评分系统变化。结果试验3组总有效率为66.7%,高于试验1、2组的58.3%和50.0%(P<0.05)。试验1、2组总有效率比较差异无统计学意义(P>0.05)。试验3组细菌总清除率为58.3%,高于试验1、2组的41.7%和16.7%(P<0.05)。试验1、2组总有效率比较差异有统计学意义(P<0.05)。治疗后,3组T、WBC、N%、PCT、APACHEⅡ评分均低于治疗前,差异有统计学意义(P<0.05)。结论亚胺培南/西司他丁输注3 h能改善重症泛耐药鲍曼不动杆菌感染患者的疗效,适合应用于临床治疗中。
Objective To observe and compare the combination of tigecycline and imipenem / cilastatin, imipenem / cilastatin combined with cefoperazone and sulbactam, to prolong the combination of imipenem / cilastatin intravenous infusion time Effect of cefoperazone and sulbactam on the efficacy of severe pan - drug resistant Acinetobacter baumannii. Methods Thirty-six patients with severe pan-drug-resistant Acinetobacter baumannii infection in the department of critical medicine were randomly divided into two groups (experimental group 1, 2, and 3), with 12 patients in each group. Patients were given tigecycline combined with imipenem / Cetiding, imipenem / cilastatin combined with cefoperazone sulbactam, prolonged imipenem / cilastatin intravenous infusion combined with cefoperazone sulbactam treatment, the clinical efficacy of the three groups were compared , Bacteriological efficacy, laboratory data, scoring system changes. Results The total effective rate in trial 3 was 66.7%, which was higher than 58.3% and 50.0% in experimental 1 and 2 (P <0.05). There was no significant difference in the total effective rate between the two groups (P> 0.05). The total bacterial clearance rate in trial 3 was 58.3%, which was higher than 41.7% and 16.7% of those in trial 1 and 2 (P <0.05). The total effective rate in trial 1 and 2 was significantly different (P <0.05). After treatment, the scores of T, WBC, N%, PCT and APACHE Ⅱ in three groups were all lower than those before treatment, the difference was statistically significant (P <0.05). Conclusion The imipenem / cilastatin 3 h infusion can improve the efficacy of severe pan-drug-resistant Acinetobacter baumannii infection and is suitable for clinical treatment.