哌拉西林/他唑巴坦联合乙酰半胱氨酸溶液对脑梗死后并发重症肺炎的治疗效果

Therapeutic effects of piperacillin/tazobactam combined with acetylcysteine solution on severe pneumonia after cerebral infarction

    摘要
  • 摘要:
    目的 探讨哌拉西林/他唑巴坦联合乙酰半胱氨酸溶液对脑梗死后并发重症肺炎的治疗效果，并分析对心肺功能及神经功能的影响。
    方法 选取榆林市星元医院2022年1月-2024年6月收治的86例脑梗死后并发重症肺炎患者，采用随机数字表法(单盲)将86例脑梗死后并发重症肺炎患者分为对照组与研究组，各43例，对照组采用哌拉西林/他唑巴坦静脉滴注治疗，研究组在对照组的基础上联合吸入用乙酰半胱氨酸溶液雾化吸入治疗。比较治疗前后两组患者炎症因子C-反应蛋白(CRP)及白细胞介素-6(IL-6)、降钙素原(PCT)水平、肺功能指标用力肺活量(FVC)、最高呼气流速(PEF)、第1秒用力呼气容积(FEV1)、平均最大呼气流量(MMEF)、心功能指标左心室射血分数(LVEF)、心输出量(CO)、心脏排血指数(CI)、每搏输出量(SV)、美国国立卫生研究院卒中量表(NIHSS)评分、临床疗效及不良反应发生情况。
    结果 与对照组相比，研究组治疗后CRP、IL-6、PCT水平及NIHSS评分更低(P < 0.05)，研究组治疗后FVC、PEF、FEV1、MMEF、LVEF、CO、CI及SV水平更高(P < 0.05)。研究组治疗总有效率为95.35%，高于对照组的81.40%(χ2=4.074，P=0.044)；治疗期间对照组与研究组脑梗死后并发重症肺炎患者不良反应发生情况差异无统计学意义(χ2=0.179，P=0.672)。
    结论 哌拉西林/他唑巴坦联合吸入用乙酰半胱氨酸溶液治疗脑梗死后并发重症肺炎患者，能提高临床疗效，降低炎症因子水平，改善患者心肺和神经功能，安全性较高。

     

    Abstract:
    OBJECTIVE To explore the effects of piperacillin/tazobactam combined with acetylcysteine solution on severe pneumonia after cerebral infarction, and to analyze its impact on cardiopulmonary and neurological function.
    METHODS A total of 86 patients with severe pneumonia after cerebral infarction admitted to Yulin Xingyuan Hospital from Jan. 2022 to Jun. 2024 were selected and divided into a control group and a study group using the random number table method (single blind), with 43 cases in each group. The control group was treated with intravenous drip of piperacillin/tazobactam, while the study group received additional inhalation of acetylcysteine solution based on the control group′s treatment. The levels of inflammatory factors C-reactive protein (CRP), interleukin-6 (IL-6) and procalcitonin (PCT), lung function indicators forced vital capacity (FVC), peak expiratory flow rate (PEF), forced expiratory volume in one second (FEV1) and mean maximal expiratory flow rate (MMEF), cardiac function indicators left ventricular ejection fraction (LVEF), cardiac output (CO), cardiac index (CI) and stroke volume (SV), NIH Stroke Scale (NIHSS) score, clinical efficacy, and the occurrence of adverse reactions were compared before and after treatment.
    RESULTS Compared with the control group, the study group had low levels of CRP, IL-6, PCT and NIHSS scores after treatment (P < 0.05), and high levels of FVC, PEF, FEV1, MMEF, LVEF, CO, CI, and SV after treatment (P < 0.05). The overall response rate in the study group was 95.35%, higher than 81.40% in the control group (χ2= 4.074, P=0.044). There was no statistically significant difference in the incidence of adverse reactions between the control group and the study group during treatments (χ2= 0.179, P=0.672).
    CONCLUSION Piperacillin/tazobactam combined with inhaled acetylcysteine solution for the treatment of severe pneumonia after cerebral infarction can improve clinical efficacy, reduce levels of inflammatory factors, and enhance cardiopulmonary and neurological functions in patients, which has a high safety profile.

     

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