哌拉西林舒巴坦联合阿奇霉素治疗社区获得性小儿肺炎疗效观察.docVIP

哌拉西林舒巴坦联合阿奇霉素治疗社区获得性小儿肺炎疗效观察 　　【摘要】 目的 ?^察哌拉西林舒巴坦联合阿奇霉素治疗社区获得性小儿肺炎患儿的临床疗效。方法 120例社区获得性肺炎患儿， 随机分为对照组和试验组， 每组60例。两组患儿均进行常规治疗， 对照组患儿另外给予阿奇霉素治疗， 试验组在对照组治疗基础上加用哌拉西林舒巴坦治疗。观察比较两组患儿的临床疗效、症状（包括咳嗽、退热、鸣音）消失时间、住院时间及不良反应发生情况。结果 试验组患儿总有效率96.67%显著高于对照组的85.00%， 差异具有统计学意义（P0.05）。结论 哌拉西林舒巴坦联合阿奇霉素治疗社区获得性小儿肺炎具有良好的的临床效果， 值得进一步临床应用和研究。 　　【关键词】 社区获得性肺炎；哌拉西林舒巴坦；阿奇霉素；小儿肺炎 　　DOI：10.14163/j.cnki.11-5547/r.2018.11.001 　　【Abstract】 Objective To observe the clinical efficacy of piperacillin and sulbactam combined with azithromycin in the treatment of community-acquired pneumonia in children. Methods A total of 120 community-acquired pneumonia children were randomly divided into control group and experimental group， with 60 cases in each group. Both groups received conventional therapy， and the control group was also treated with azithromycin. The experimental group was treated with piperacillin and sulbactam on the basis of the control group. Observation and comparison were made on clinical efficacy， symptom （including coughing， fever， and wheezing） disappearance time， hospitalization time and occurrence of adverse reactions between the two groups. Results The experimental group had significantly higher total effective rate as 96.67% than 85.00% in the control group， and the difference was statistically significant （P0.05）. Conclusion Combination of piperacillin and sulbactam and azithromycin shows excellent clinical effect in treating community-acquired pneumonia in children， and it is worthy of further clinical application and study. 　　【Key words】 Community-acquired pneumonia； Piperacillin and sulbactam； Azithromycin； Pediatric pneumonia 　　社区获得性肺炎是指在医院外感染的肺实质性炎性反应[1]， 多见于春冬季节， 好发于幼儿群体[2]。引起该炎症的病原体包括细菌、衣原体、支原体和病毒等。有学者统计了国内儿童社区获得性肺炎的病因， 支原体所引起的比例占25%[3]。该病的早起症状主要是鼻炎样症状或者上呼吸道感染[4]， 严重者可以出现剧烈高热和咳嗽， 甚至出现惊厥危及生命。早期， 治疗小儿肺炎最有效的药物为大环内酯类抗生素[5]， 包括了红霉素， 后来出现了结构类似， 但明显改善小儿耐受性和减少副作用的阿奇霉素[6]。哌拉西林是青霉素类光谱抗生素， 而舒巴坦可以抑制β-内酰胺酶， 从而保护哌拉西林不被水解， 发挥哌拉西林的抑菌作用[4]。本研究选取本院在2015年1月～2016年12月收治的肺炎患儿， 观察阿奇霉素和哌拉西林舒巴坦联