目的 探討血必凈注射液聯(lián)合頭孢他啶治療多重耐藥肺炎克雷伯桿菌肺炎的臨床療效。方法 選取2020年8月—2023年2月聊城市第二人民醫(yī)院收治的106例多重耐藥肺炎克雷伯桿菌肺炎患者，按隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各53例。對(duì)照組iv注射用頭孢他啶，2 g加至0.9%生理鹽水100 mL，1次/12 h。治療組在此基礎(chǔ)上iv血必凈注射液，50 mL加入0.9%生理鹽水100 mL，2次/d，每次滴注時(shí)間30～40 min。兩組療程均為14 d。觀察兩組臨床療和臨床表現(xiàn)消失時(shí)間，比較兩組治療前后氧合指數(shù)（OI）、呼吸頻率（RR）、肺炎胸片吸收評(píng)價(jià)量表（PCRAES）評(píng)分、全血C反應(yīng)蛋白（CRP）和血清降鈣素原（PCT）、白細(xì)胞介素（IL）-6、淀粉樣蛋白A（SAA）水平的變化情況。結(jié)果 治療后，治療組總有效率是94.34%，顯著高于對(duì)照組的81.13%（P＜0.05）。治療后，兩組發(fā)熱、咳嗽、咳痰、肺部啰音、白細(xì)胞異常的消失時(shí)間均顯著短于對(duì)照組（P＜0.05）。治療后，兩組OI均顯著增高，而RR和PCRAES評(píng)分均顯著降低（P＜0.05）；治療后，治療組OI、RR和PCRAES評(píng)分改善優(yōu)于對(duì)照組（P＜0.05）。治療后，兩組全血CRP和血清PCT、IL-6、SAA水平均顯著下降（P＜0.05）；治療后，治療組全血CRP和血清PCT、IL-6、SAA水平均顯著低于對(duì)照組（P＜0.05）。結(jié)論 血必凈注射液聯(lián)合頭孢他啶治療多重耐藥肺炎克雷伯桿菌肺炎效果確切，能有效控制患者臨床表現(xiàn)，解除氣道堵塞，增強(qiáng)呼吸功能，緩解肺部感染及機(jī)體炎癥狀態(tài)。

Objective To explore the clinical efficacy of Xuebijing Injection combined with ceftazidime in treatment of multidrug-resistant Klebsiella pneumoniae pneumonia. Methods A total of 106 patients with multidrug-resistant klebsiella pneumoniae pneumonia admitted to the Second People’s Hospital of Liaocheng from August 2020 to February 2023 were selected and divided into control group and treatment group according to random number table method, with 53 cases in each group. Patients in control group were iv administered with Ceftazidime for injection, 2 g was added to 0.9% normal saline 100 mL, once 12 h. Patients in treatment group were po administered with Xuebijing Injection on the basis of the control group, 50 mL was added to 0.9% normal saline 100 mL, twice daily, each infusion time from 30 to 40 min. The treatment course of both groups was 14 d. Clinical treatment and disappearance time of clinical manifestations of the two groups were observed, and the changes of oxygenation index (OI), respiratory rate (RR), PCRAES score, whole blood C-reactive protein (CRP), serum procalcitonin (PCT), interleukin-6 and amyloid A (SAA) levels before and after treatment were compared between two groups. Results After treatment, the total effective rate of treatment group was 94.34%, which was significantly higher than that of control group (81.13%, P < 0.05). After treatment, the disappearance time of fever, cough, sputum, lung rales and leukocyte abnormalities in 2 groups was significantly shorter than that in control group (P < 0.05). After treatment, OI was significantly increased in both groups, but RR and PCRAES scores were significantly decreased (P < 0.05). After treatment, the improvement of OI, RR and PCRAES scores in treatment group was better than that in control group (P < 0.05). After treatment, whole blood CRP and serum PCT, IL-6 and SAA levels in both groups were significantly decreased (P < 0.05). After treatment, whole blood CRP, serum PCT, IL-6 and SAA levels in treatment group were significantly lower than those in control group (P < 0.05). Conclusion Xuebijing Injection combined with ceftazidime has exact effect in treatment of multidrug-resistant Klebsiella pneumoniae pneumonia, and can effectively control the clinical manifestations of patients, relieve airway blockage, enhance respiratory function, which can relieve lung infection and body inflammation.

R974

聊城市重點(diǎn)研發(fā)計(jì)劃政策引導(dǎo)類項(xiàng)目（2022YDSF48）