首页|静脉滴注联合雾化吸入多黏菌素B治疗碳青霉烯耐药革兰阴性杆菌肺炎的临床研究

静脉滴注联合雾化吸入多黏菌素B治疗碳青霉烯耐药革兰阴性杆菌肺炎的临床研究

Clinical study on intravenous combined with nebulized inhalation of polymyxin B in treatment of carbapenem-resistant organism pneumonia

扫码查看
目的 对比单纯静脉滴注多黏菌素B和静脉滴注联合雾化吸入多黏菌素B治疗碳青霉烯耐药革兰阴性杆菌(carbapenem-resistant organism,CRO)肺炎患者的临床疗效.方法 采用回顾性研究的方法,收集南京鼓楼医院重症医学科2020年9月-2023年6月收治的85例CRO肺炎患者的临床资料.根据患者多黏菌素B用药方式的不同,将接受多黏菌素B单纯静脉滴注治疗的患者纳入A组,接受多黏菌素B静脉滴注联合雾化吸入治疗的患者纳入B组.比较两组患者用药后治疗有效率、细菌清除率、30天全因死亡率以及用药前后感染指标水平.观察记录两组患者用药期间急性肾损伤发生情况.结果 病原学培养结果显示,两组病原学培养结果比较差异无统计学意义(P=0.144).两组患者用药后血清降钙素原、C反应蛋白较用药前明显降低(均P<0.05).B组患者治疗有效率和细菌清除率均高于A组患者(均P<0.05).两组患者30天全因死亡率差异无统计学意义(P=0.664).两组患者不良反应发生率差异无统计学意义(P=0.650).结论 多黏菌素B用于治疗CRO肺炎患者时,静脉滴注联合雾化吸入治疗方案优于单纯静脉滴注治疗,且不增加肾毒性发生的风险.
Objective To compare the clinical efficacy of intravenous polymyxin B alone and intravenous drip combined with nebulized inhaled polymyxin B in treatment of patients with carbapenem-resistant organism(CRO)pneumonia.Methods The clinical data of 85 patients with CRO pneumonia admitted to the Intensive Care Unit of Nanjing Drum Tower Hospital from September 2020 to June 2023 were collected using a retrospective study.According to the different ways of administration of polymyxin B,the patients receiving polymyxin B intravenous drip therapy alone were included in group A,and the patients receiving polymyxin B intravenous drip therapy combined with nebulized inhalation therapy were included in group B.The therapeutic effective rate,bacterial clearance rate,30-day all-cause mortality and the level of infection indexes before and after the use of medication were compared between the two groups.The occurrence of acute kidney injury during the use of drugs in the two groups was observed and recorded.Results The pathogenicity culture results showed that there was no statistically significant difference between the two groups(P=0.144).Serum procalcitonin and C-reactive protein were significantly lower in the two groups after drug administration compared with those before drug administration(both P<0.05).The therapeutic efficiency and bacterial clearance rate in group B were higher than those in group A(both P<0.05).There was no statistically significant difference in 30-day all-cause mortality between the two groups(P=0.664).And there was no statistically significant difference in the incidence of adverse reactions between the two groups(P=0.650).Conclusion When polymyxin B is used to treat patients with CRO pneumonia,the intravenous drip combined with nebulized inhalation regimen is superior to intravenous drip therapy alone and does not increase the risk of developing nephrotoxicity.

Polymyxin Bnebulized inhalationintravenous drippneumoniacarbapenem-resistant bacteriaclinical efficacy

袁宾彬、徐颖、王倩、陈丽秋、梁培、顾勤

展开 >

南京中医药大学鼓楼临床医学院(江苏南京 210008)

南京大学医学院附属鼓楼医院(江苏南京 210008)

中国药科大学南京鼓楼医院(江苏南京 210008)

多黏菌素B 雾化吸入 静脉滴注 肺炎 碳青霉烯类耐药菌 临床疗效

2024

中国呼吸与危重监护杂志
四川大学华西医学中心,四川大学华西医院

中国呼吸与危重监护杂志

CSTPCD
影响因子:1.306
ISSN:1671-6205
年,卷(期):2024.23(6)
  • 11