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目的观察头孢哌酮舒巴坦静脉滴注加雾化吸入治疗呼吸机相关性肺炎的临床疗效。方法 60例符合纳入标准的呼吸机相关性肺炎患者,根据就诊顺序,用随机数字表法随机(1∶1)分为两组各30例。对照组在基础治疗上加用头孢哌酮舒巴坦静脉滴注,2g/次,每8h 1次,7d后改为每12h 1次,连用14d为1个疗程。治疗组在对照组基础上加用头孢哌酮舒巴坦2g加入生理盐水2ml中,用PARI雾化泵雾化吸入,5～10min/次,2～4次/d。结果①两组疗效比较:对照组平均秩次为24.35,治疗组平均秩次为36.65。Mann-Whitney U统计量为265.00,Wilcoxon W为730.00,Z检验统计量为Z=-2.824,P=0.005(双侧),两组疗效有显著性差异,治疗组优于对照组;②总有效率治疗组为90.00%,对照组为66.67%,两组比较:χ2=4.812,ν=1,P=0.028,有显著性差异,治疗组优于对照组;③清除率治疗组为88.00%,对照组为62.50%,两组比较:χ2=4.306,ν=1,P=0.038,有显著性差异,治疗组优于对照组;④两组患者均按时完成了治疗,未发现该治疗方法有明显不良反应。结论头孢哌酮舒巴坦静脉滴注加雾化吸入治疗呼吸机相关性肺炎具有较好的临床疗效,细菌清除率高,副作用小,值得临床进一步研究。
Objective To observe the clinical efficacy of cefoperazone sulbactam intravenous drip plus nebulization inhalation in the treatment of ventilator-associated pneumonia. Methods Sixty patients with ventilator - associated pneumonia who met the inclusion criteria were randomly divided into two groups of 30 patients (1: 1) according to the order of treatment. The control group in the basic treatment with cefoperazone sulbactam intravenous infusion, 2g / time, once every 8h, 7d after every 12h 1, once every 14d for a course of treatment. On the basis of the control group, 2 g of cefoperazone sulbactam was added in the treatment group to 2 ml of normal saline, and inhaled with PARI atomization pump for 5 to 10 min, twice to 4 times per day. Results ① Comparison of the two groups: the average rank of the control group was 24.35, and the average rank of the treatment group was 36.65. Mann-Whitney U statistic was 265.00, Wilcoxon W was 730.00, Z test statistic was Z = -2.824, P = 0.005 (both sides), there was significant difference between the two groups, the treatment group was better than the control group; The efficiency of the treatment group was 90.00%, the control group was 66.67%, the two groups were compared: χ2 = 4.812, ν = 1, P = 0.028, there was a significant difference in the treatment group than the control group; The control group was 62.50%, the two groups were compared: χ2 = 4.306, ν = 1, P = 0.038, there was a significant difference, the treatment group was better than the control group; ④The two groups of patients completed the treatment on time, did not find the treatment Obvious adverse reaction. Conclusion Cefoperazone sulbactam intravenous drip plus inhalation therapy has a good clinical efficacy in ventilator-associated pneumonia, bacterial clearance rate, side effects, it is worth further clinical study.