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目的:评价哌拉西林/他唑巴坦治疗小儿恶性实体瘤相关肺部感染的疗效和安全性。方法:小儿外科收治的恶性实体肿瘤患儿68例,根据痰培养和药敏结果将患儿分成两组:哌拉西林/他唑巴坦钠治疗治疗组(n=38)与头孢米诺钠治疗组(n=30),疗程均为7-14天。比较两组患儿症状、体征、血白细胞、C反应蛋白及痰培养恢复情况及疗效。结果:两组治疗前后C-反应蛋白(t=0.239,P=0.812)、白细胞计数(t=0.656,P=0.514)及中性粒细胞百分比(t=1.501,P=0.138)的变化对比;两组临床有效率分别为94.74%和93.33%(X~2=0.060,P=0.807),上述差异均无统计学意义;而两组治疗时间比较差异有统计学意义(t=2.424,P=0.018)。两组痰培养致病菌均以铜绿假单胞菌为首,细菌清除率分别为84.38%和76.00%,差异无统计学意义(F=0.634,P=0.446)。两组用药过程中均无不良反应发生。结论:哌拉西林/他唑巴坦在小儿恶性实体瘤化疗过程中出现的肺部感染的治疗中疗效明显,安全性好。
OBJECTIVE: To evaluate the efficacy and safety of piperacillin / tazobactam in the treatment of pulmonary infections associated with malignant solid tumors in children. Methods: Sixty-eight children with malignant solid tumors admitted to pediatric surgery were divided into two groups according to sputum culture and drug susceptibility results: piperacillin / tazobactam sodium treatment group (n = 38) and cefminox sodium Treatment group (n = 30), treatment are 7-14 days. Symptoms, signs, white blood cells, C-reactive protein and sputum culture recovery and efficacy of two groups were compared. Results: The changes of C - reactive protein (t = 0.239, P = 0.812), leukocyte count (t = 0.656, P = 0.514) and neutrophil percentage (t = 1.501, P = 0.138) The clinical effective rates of the two groups were 94.74% and 93.33% (X ~ 2 = 0.060, P = 0.807) respectively. There was no significant difference between the two groups (t = 2.424, P = 0.018). The pathogenic bacteria of sputum culture in both groups were led by Pseudomonas aeruginosa. The bacterial clearance rate was 84.38% and 76.00%, respectively, with no significant difference (F = 0.634, P = 0.446). No adverse reactions occurred during the two groups. CONCLUSION: Piperacillin / tazobactam has obvious curative effect and good safety in the treatment of pulmonary infection in pediatric malignant solid tumor during chemotherapy.