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目的观察哌拉西林/他唑巴坦(4∶1)用于ICU重症脓毒症患者经验性抗感染治疗的临床疗效。方法 60例重症脓毒症患者随机分为治疗组和对照组,各30例,在同样给予液体复苏等其他相同治疗外,治疗组给予哌拉西林/他唑巴坦(4∶1)、对照组给予头孢噻肟均静脉滴注,分别进行经验性抗感染治疗72h后,比较炎症指标、APACHEⅡ评分的变化,并评价临床疗效及其安全性。结果治疗组较对照组无论在炎症指标白细胞计数、超敏C反应蛋白、前降钙素还是APACHEⅡ评分的改善方面均占优势;治疗组和对照组总痊愈率和有效率分别为76.7%和60.0%、90.0%和76.7%,两组比较差异均有统计学意义(P<0.05);哌拉西林/他唑巴坦组未出现严重不良反应。结论哌拉西林/他唑巴坦(4∶1)可作为重症脓毒症患者经验性抗感染治疗的一种广谱、安全有效的抗菌药物。
Objective To observe the clinical efficacy of piperacillin / tazobactam (4:1) for the treatment of empiric anti-infectives in patients with severe sepsis in ICU. Methods Sixty patients with severe sepsis were randomly divided into treatment group (n = 30) and control group (n = 30). Piperacillin / tazobactam (4:1) was given to the treatment group in addition to other similar treatments such as liquid resuscitation. Group were given cefotaxime intravenous infusion, respectively, after empirical anti-infective therapy for 72h, the comparison of inflammatory markers, APACHE Ⅱ score changes, and evaluate the clinical efficacy and safety. Results Compared with the control group, the treatment group and the control group both dominated the improvement of white blood cell count, hypersensitive C-reactive protein, procalcitonin or APACHEⅡ score. The total cure rate and effective rate of the treatment group and the control group were 76.7% and 60.0% %, 90.0% and 76.7%, respectively, with significant difference between the two groups (P <0.05). No serious adverse reactions occurred in the piperacillin / tazobactam group. Conclusion Piperacillin / tazobactam (4:1) can be used as a broad-spectrum, safe and effective antimicrobial agent for empirical anti-infective therapy in patients with severe sepsis.