梁开丽 黄玉仕

[摘要]目的 探讨哌拉西林-他唑巴坦与阿米卡星联用对支气管扩张伴感染患者的影响。方法 选取2016年2月～2018年8月我院收治的198例支气管扩张伴感染患者，按照治疗方法的不同分为对照组和观察组。对照组（98例）采用硫酸依替米星治疗，观察组（100例）采用哌拉西林-他唑巴坦与阿米卡星联用治疗。观察两组的咳嗽咳痰消失时间、体温恢复正常时间、咯血消失时间;观察两组的治疗前后第1秒用力呼气量（FEV1）、用力呼气量（FVC）和FEV1/FVC情况，观察两组的临床治疗效果。结果 观察组的咳嗽咳痰消失时间、体温恢复正常时间、咯血消失时间均短于对照组，差异有统计学意义（P<0.05）.两组治疗前FEV1、FVC、FEV1/FVC比较，差异无统计学意义（P>0.05），治疗后两组的FEV1、FVC、FEV1/FVC均高于治疗前，观察组治疗后FEV1、FVC、FEV1/FVC高于对照组，差异有统计学意义（P<0.05）。观察组治疗总有效率高于对照组，差异有统计学意义（P<0.05）。结论 哌拉西林-他唑巴坦与阿米卡星联用治疗支气管扩张伴感染患者，临床症状改善时间缩短，提高了肺功能和临床治疗效果，值得临床推广应用。

[关键词]哌拉西林-他唑巴坦;硫酸阿米卡星;支气管扩张;感染

[中图分类号] R472          [文獻标识码] A          [文章编号] 1674-4721（2019）6（c）-0081-03

[Abstract] Objective To investigate the effect of Piperacillin-Tazobactam combined with Amikacin on patients with bronchiectasis and infection. Methods The clinical data of 198 patients with bronchiectasis-associated infection who treated in our hospital from February 2016 to August 2018 were selected. According to different therapeutic methods， they were divided into the control group （treated with Etimicin Sulfate， n=98） and the observation group （Piperacillin-Tazobactam combined with Amikacin， n=100）. The disappearance time of cough and expectoration， the time of body temperature returning to normal， disappearance time of hemoptysis were observed between the two groups. In addition， the forced expiratory volume 1 second before and after treatment （FEV1）， forced vital capacity （FVC） and FEV1/FVC were also observed as well as the clinical efficacy. Results The time of cough and expectoration disappeared， the time of body temperature returned to normal， and the time of hemoptysis disappeared in the observation group were shorter compared with those in the control group with statistical significance （P<0.05）. There was no significant difference in FEV1， FVC and FEV1/FVC between the two groups before treatment. After treatment， the FEV1， FVC and FEV1/FVC in the control and observation groups were all higher than those before treatment， respectively. The FEV1， FVC and FEV1/FVC in the observation group after treatment were all higher compared with those in the control group （P<0.05）. The total clinical effectiveness rate in the observation group was higher than that of the control group， the difference was statistically significant （P<0.05）. Conclusion Piperacillin-Tazobactam combined with Amikacin in the treatment of patients with bronchiectasis and infection can shorten the improvement time of clinical symptoms， enhance the lung function and clinical efficacy， and is worthy of clinical application.

[Key words] Piperacillin-Tazobactam; Amikacin Sulfate; Bronchiectasis; Infection

支气管扩张是由支气管堵塞、支气管肺组织感染诱发的，和患者机体免疫失调、遗传因素、解剖缺陷和先天性发育异常等密切相关[1-2]。因支气管扩张管壁結构常会受到损伤，引流不通畅，反复性发作，容易继发感染，抗菌药物又造成菌群失调，影响临床治疗效果[3-4]。支气管扩张反复发展，造成支气管持续性扩张，出现慢性咳嗽、咳痰，甚至反复性咯血[5]。本研究分析我院收治的198例支气管扩张伴感染患者临床资料，探讨哌拉西林-他唑巴坦与阿米卡星联用治疗支气管扩张伴感染的临床效果，现报道如下。

1资料与方法

1.1一般资料