【摘要】 目的探讨哌拉西林-他唑巴坦(特治星)对颅脑损伤病人医院获得性肺炎(HAP)经验性治疗的有效性和安全性。方法将脑科重症监护室(NICU)100例颅脑损伤合并HAP的病人随机分为特治星组和头孢曲松钠组,各50例,分别应用特治星及头孢曲松钠治疗7d,进行实验前后的下气道分泌物培养、大便菌群分析、胸部X线平片检查,记录每日体温、血常规、有无腹泻及腹泻出现的时间,比较两组病人治疗的有效性和安全性。结果气道分泌物共培养出细菌104株,其中革兰阴性菌88株,革兰阳性球菌16株,两组主要致病菌均为肺炎克雷伯杆菌、铜绿假单胞菌、鲍氏不动杆菌。特治星组治疗HAP临床有效率、细菌清除率、不良反应发生率分别为78%、73%、18%,头孢曲松钠组为52%、44%、34%,两组比较差异均有显著性(χ2=4.17～10.92,P<0.05)。结论NICU颅脑损伤病人HAP病原体前3位为肺炎克雷伯杆菌、铜绿假单胞菌、鲍氏不动杆菌。特治星在颅脑损伤病人HAP的经验性治疗中有较好的临床疗效和细菌学疗效,且不良反应发生率较低。更多还原

【Abstract】 Objective To assess the efficacy and safety of piperacillin sodium and tazobactam sodium(Tazocin in) empi-rical therapy for nosocomial pneumonia(NP) in patients with craniocerebral injury(CCI).Methods This study consisted of 100 patients with CCI accompanying NP treated in NICU,who were evenly randomized to tazocin group and ceftriaxone group.The patients were given tazocin and ceftriaxone,respectively,for seven days.Before and after therapy,sputum cultures,intestinal flora analysis and lung X-ray were conducted.Body temperature,blood routine,and whether or not having diarrhea were recorded.The therapeutic efficacy and safety between the two groups were compared.Results Sputum cultures showed 104 strains(G-,88 and G+,16).The top three strains were Klebsiella pneumoniae,pseudomonas aeruginosa and Acinetobacter baumann.In the tazocin group,the effective power for NP,bacterial clearance rate and rate of adverse reactions were 78%,73% and 18%,respectively;in the ceftriaxone group,that were 52%,44% and 34%,the differences being significant between the two groups(χ2=4.17-10.92,P<0.05).ConclusionThe top three bacterial strains of NP in CCI patients in NICU were Klebsiella pneumoniae,pseudomonas aeruginosa and Acinetobacter baumann.Tazocin has a better clinical and bacteriological effect in empirical therapy for NP with low adverse reactions.更多还原