【摘要】 目的探讨吸入噬菌体联合头孢克肟治疗重症监护室(ICU)多重/泛耐药菌肺炎的临床疗效及对患者炎性因子水平的影响。方法选取医院2016年2月至2019年2月收治的ICU多重/泛耐药菌肺炎患者64例,按随机号码法分为对照组和治疗组,各32例。两组患者均予头孢克肟分散片口服,治疗组患者加用吸入噬菌体,均持续治疗7 d。结果治疗组总有效率为96.88%,显著高于对照组的62.50%(P <0.05);治疗组患者28 d和60 d的死亡率分别为0和3.12%,显著低于对照组的15.62%和37.50%(P <0.05);治疗组患者的ICU机械通气时长和住院时长均显著短于对照组(P <0.05);治疗1,2,3,5,7,15 d后,治疗组患者的C反应蛋白(CRP)、白细胞介素6(IL-6)、降钙素原(PCT)水平均显著低于对照组(P <0.05),治疗组与对照组不良反应发生率相当(9.38%比12.50%,P>0.05)。结论吸入噬菌体联合头孢克肟治疗ICU多重/泛耐药菌肺炎,可明显改善患者的临床结局及各项ICU临床指标,降低炎性因子水平。更多还原

【Abstract】 Objective To investigate the effect of inhalation of bacteriophage combined with cefixime on the levels of inflammatory factors in patients with multiple/pan-resistant bacterial pneumonia in intensive care unit( ICU). Methods Sixty-four patients with multiple/pan-drug-resistant bacterial pneumonia in ICU from February 2016 to February 2019 were selected and divided into the control group and treatment group by random number method,32 cases in each group. The control group was treated with cefixime,while the treatment group was treated with inhaled bacteriophage combined with cefixime. Results The total effective rate of the treatment group was 96. 88%,which was significantly higher than 62. 50% of the control group( P < 0. 05). The mortality rates of 28 and 60 d in the treatment group were 0 and 3. 12% respectively,which were significantly lower than15. 62% and 37. 50% in the control group( P < 0. 05). The ICU mechanical ventilation days and hospitalization days in the treatment group were significantly shorter than those in the control group( P < 0. 05). After 1,2,3,5,7 and 15 d of treatment,the levels of C-reactive protein( CRP),interleukin-6( IL-6),and procalcitonin( PT) in the treatment group were significantly lower than those in the control group( P < 0. 05). The incidence of adverse reactions in the treatment group had no significant difference compared with the control group( 9. 38 % vs. 12. 50 %,P > 0. 05).Conclusion Inhalation of bacteriophage combined with cefixime is effective in the treatment of multiple/pan-drug-resistant bacterial pneumonia in ICU. It can significantly improve the clinical outcomes,clinical indicators of ICU,and reduce the level of inflammatory factors.更多还原