头孢他啶钠联合阿奇霉素治疗小儿肺炎支原体肺炎的临床疗效及安全性探讨
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摘要
目的观察头孢他啶钠联合阿奇霉素治疗小儿肺炎支原体肺炎的临床疗效及安全性。方法选取2016年7月～2018年3月收治的108例肺炎支原体肺炎患儿作为研究对象,按照随机数字法则分为两组,每组54例,对照组采用阿奇霉素进行治疗,研究组采用头孢他啶钠联合阿奇霉素进行治疗。然后对比两组治疗后的总有效率、临床症状改善效果(退热时间、肺部啰音消退时间、咳嗽喘息消退时间和住院时间)及两组患儿不良反应发生率。结果研究组肺炎支原体肺炎患儿总有效率为98.1%,明显高于对照组(85.2%)(P<0.05);研究组肺炎支原体肺炎患儿退热时间、肺部啰音消退时间、咳嗽喘息消退时间和住院时间均明显少于对照组(P<0.05);研究组肺炎支原体肺炎患儿不良反应发生率明显低于对照组(P<0.05)。结论头孢他啶钠联合阿奇霉素治疗小儿肺炎支原体肺炎的治疗效果更佳,能够有效控制患儿病情,改善症状,有效降低用药的不良反应,安全有效,值得在临床治疗中广泛应用。
Objective To observe the clinical efficacy and safety of ceftazidime sodium combined with azithromycin in the treatment of children with mycoplasma pneumoniae pneumonia(MPP). Methods 108 children with pneumoniae pneumonia admitted from July 2016 to March 2018 were enrolled in the study. They were divided into two groups according to random number rule, 54 cases in each group. The control group was treated with azithromycin. The study group was given ceftazidime sodium combined with azithromycin for treatment. The total effective rate after treatment,the clinical symptoms improvement(antipyretic time, lung rale regression time, cough and wheezing regression time and hospitalization time), and the incidence of adverse reactions in the two groups were compared. Results The total effective rate of children with mycoplasma pneumoniae pneumonia in the study group was 98.1%, which was significantly higher than that of the control group(85.2%)(P<0.05). The antipyretic time, lung rale regression time, cough and wheezing regression time and hospitalization time were significantly shorter in the study group than in the control group(P<0.05). The incidence of adverse reactions of study group was lower than that of the control group(P<0.05). Conclusion The combination of ceftazidime sodium and azithromycin in the treatment of children with mycoplasma pneumoniae pneumonia has better therapeutic effect, which can effectively improve the children's condition, relieve the disease, and reduce the adverse reactions of medication, with high safety and effectiveness, thus is worthy of wide application in clinical treatment.
Objective To observe the clinical efficacy and safety of ceftazidime sodium combined with azithromycin in the treatment of children with mycoplasma pneumoniae pneumonia(MPP). Methods 108 children with pneumoniae pneumonia admitted from July 2016 to March 2018 were enrolled in the study. They were divided into two groups according to random number rule, 54 cases in each group. The control group was treated with azithromycin. The study group was given ceftazidime sodium combined with azithromycin for treatment. The total effective rate after treatment,the clinical symptoms improvement(antipyretic time, lung rale regression time, cough and wheezing regression time and hospitalization time), and the incidence of adverse reactions in the two groups were compared. Results The total effective rate of children with mycoplasma pneumoniae pneumonia in the study group was 98.1%, which was significantly higher than that of the control group(85.2%)(P<0.05). The antipyretic time, lung rale regression time, cough and wheezing regression time and hospitalization time were significantly shorter in the study group than in the control group(P<0.05). The incidence of adverse reactions of study group was lower than that of the control group(P<0.05). Conclusion The combination of ceftazidime sodium and azithromycin in the treatment of children with mycoplasma pneumoniae pneumonia has better therapeutic effect, which can effectively improve the children's condition, relieve the disease, and reduce the adverse reactions of medication, with high safety and effectiveness, thus is worthy of wide application in clinical treatment.
引文
[1]王新芬.阿奇霉素联合布地奈德混悬液雾化吸入治疗小儿肺炎支原体肺炎53例疗效观察[J].中国中西医结合儿科学,2014,6(1):55-57.
[2]陈嘉慧,印根权,余嘉璐,等.红霉素与阿奇霉素治疗小儿肺炎支原体肺炎的临床研究[J].中国临床药理学杂志,2015,31(8):587-589.
[3]Raz-Pasteur A,Shasha D,Paul M.Fluoroquinolones or macrolides alone versus combined withβ-lactams for adults with community-acquired pneumonia:Systematic review and meta-analysis[J].International Journal of Antimicrobial Agents,2015,46(3):242-248.
[4]黄梅.小儿肺炎支原体肺炎临床表现及发病机制分析[J]中国妇幼保健,2014,29(2):223-225.
[5]金瑄.肺炎支原体抗体联合超敏C反应蛋白检测在小儿支原体肺炎感染诊断中的临床价值[J].标记免疫分析与临床,2015,22(8):744-746.
[6]Wiersinga WJ,Bonten MJM,Boersma WG,et al.Management of community-acquired pneumonia in adults:2016 guideline update from the Dutch Working Party on Antibiotic Policy(SWAB)and Dutch Association of Chest Physicians(NVALT)[J].Netherlands Journal of Medi-cine,2018,76(1):4-13.
[7]任明星,薛国昌,沈琳娜,等.甲泼尼龙联合阿奇霉素治疗小儿难治性支原体肺炎的疗效与安全性分析[J]中国全科医学,2015,18(5):588-591.
[8]Cao B,Huang Y,She DY,et al.Diagnosis and treatment of community-acquired pneumonia in adults:2016 clinical practice guidelines by the Chinese Thoracic Society,Chinese Medical Association[J].The Clinical Respiratory Journal,2018,12(4):1320-1360.
[9]杨艳,张芳,孙之芹,等.小儿肺炎支原体肺炎的临床对照研究[J].医学综述,2014,20(2):354-356.
[10]Schwartz J,Padmanabhan A,Aqui N,et al.Guidelines on the use of therapeutic apheresis in clinical practice-evidence‐based approach from the Writing Committee of the American Society for Apheresis:the seventh special issue[J].Journal of Clinical Apheresis,2016,31(3):149-162.
[11]刘慧敏,陈富超,李春雷,等.痰热清注射液联合阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎的疗效与安全性的Meta分析[J].中医药导报,2014,20(9):45-50.
[12]Mikamo H,Matsumizu M,Nakazuru Y,et al.Efficacy and safety of metronidazole injection for the treatment of infectious peritonitis,abdominal abscess and pelvic inflammatory diseases in Japan[J].Journal of Infection and Chemotherapy,2015,21(2):96-104.
[13]陈致雯,卢焯明.阿奇霉素联合孟鲁司特钠治疗小儿肺炎支原体肺炎的临床疗效观察[J].当代医学,2014,20(5):132-133.
[14]李华浚,陈啸洪,章杭湖,等.阿奇霉素联合甲泼尼龙治疗肺炎支原体肺炎患儿的临床研究[J].中国临床药理学杂志,2015,31(10):771-773.
[15]朱春梅,曹玲.小儿肺炎支原体肺炎诊治---重症支原体肺炎并发症的诊治[J].中国实用儿科杂志,2015,30(3):161-165.
[16]章礼真.孟鲁司特钠联合布地奈德雾化吸入佐治小儿肺炎支原体肺炎30例疗效观察[J].中国中西医结合儿科学,2014,6(1):74-75.
[17]梁磊,杨泽玉,王亚亭,等.纤维支气管镜术对小儿肺炎支原体肺炎合并肺不张的诊治作用[J].医学研究生学报,2014,27(4):401-404.
[18]赵丽燕.婴幼儿肺炎支原体肺炎急性期与恢复期免疫功能及炎症因子变化[J].中国妇幼保健,2014,29(1):86-88.
[19]Liapikou A,Torres A.The clinical management of lower respiratory tract infections[J].Expert Review of Respiratory Medicine,2016,10(4):441-452.
[20]周宏春.阿奇霉素序贯法治疗小儿肺炎支原体肺炎的效果及安全性[J].中外医学研究,2014,12(7):7-8.
[2]陈嘉慧,印根权,余嘉璐,等.红霉素与阿奇霉素治疗小儿肺炎支原体肺炎的临床研究[J].中国临床药理学杂志,2015,31(8):587-589.
[3]Raz-Pasteur A,Shasha D,Paul M.Fluoroquinolones or macrolides alone versus combined withβ-lactams for adults with community-acquired pneumonia:Systematic review and meta-analysis[J].International Journal of Antimicrobial Agents,2015,46(3):242-248.
[4]黄梅.小儿肺炎支原体肺炎临床表现及发病机制分析[J]中国妇幼保健,2014,29(2):223-225.
[5]金瑄.肺炎支原体抗体联合超敏C反应蛋白检测在小儿支原体肺炎感染诊断中的临床价值[J].标记免疫分析与临床,2015,22(8):744-746.
[6]Wiersinga WJ,Bonten MJM,Boersma WG,et al.Management of community-acquired pneumonia in adults:2016 guideline update from the Dutch Working Party on Antibiotic Policy(SWAB)and Dutch Association of Chest Physicians(NVALT)[J].Netherlands Journal of Medi-cine,2018,76(1):4-13.
[7]任明星,薛国昌,沈琳娜,等.甲泼尼龙联合阿奇霉素治疗小儿难治性支原体肺炎的疗效与安全性分析[J]中国全科医学,2015,18(5):588-591.
[8]Cao B,Huang Y,She DY,et al.Diagnosis and treatment of community-acquired pneumonia in adults:2016 clinical practice guidelines by the Chinese Thoracic Society,Chinese Medical Association[J].The Clinical Respiratory Journal,2018,12(4):1320-1360.
[9]杨艳,张芳,孙之芹,等.小儿肺炎支原体肺炎的临床对照研究[J].医学综述,2014,20(2):354-356.
[10]Schwartz J,Padmanabhan A,Aqui N,et al.Guidelines on the use of therapeutic apheresis in clinical practice-evidence‐based approach from the Writing Committee of the American Society for Apheresis:the seventh special issue[J].Journal of Clinical Apheresis,2016,31(3):149-162.
[11]刘慧敏,陈富超,李春雷,等.痰热清注射液联合阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎的疗效与安全性的Meta分析[J].中医药导报,2014,20(9):45-50.
[12]Mikamo H,Matsumizu M,Nakazuru Y,et al.Efficacy and safety of metronidazole injection for the treatment of infectious peritonitis,abdominal abscess and pelvic inflammatory diseases in Japan[J].Journal of Infection and Chemotherapy,2015,21(2):96-104.
[13]陈致雯,卢焯明.阿奇霉素联合孟鲁司特钠治疗小儿肺炎支原体肺炎的临床疗效观察[J].当代医学,2014,20(5):132-133.
[14]李华浚,陈啸洪,章杭湖,等.阿奇霉素联合甲泼尼龙治疗肺炎支原体肺炎患儿的临床研究[J].中国临床药理学杂志,2015,31(10):771-773.
[15]朱春梅,曹玲.小儿肺炎支原体肺炎诊治---重症支原体肺炎并发症的诊治[J].中国实用儿科杂志,2015,30(3):161-165.
[16]章礼真.孟鲁司特钠联合布地奈德雾化吸入佐治小儿肺炎支原体肺炎30例疗效观察[J].中国中西医结合儿科学,2014,6(1):74-75.
[17]梁磊,杨泽玉,王亚亭,等.纤维支气管镜术对小儿肺炎支原体肺炎合并肺不张的诊治作用[J].医学研究生学报,2014,27(4):401-404.
[18]赵丽燕.婴幼儿肺炎支原体肺炎急性期与恢复期免疫功能及炎症因子变化[J].中国妇幼保健,2014,29(1):86-88.
[19]Liapikou A,Torres A.The clinical management of lower respiratory tract infections[J].Expert Review of Respiratory Medicine,2016,10(4):441-452.
[20]周宏春.阿奇霉素序贯法治疗小儿肺炎支原体肺炎的效果及安全性[J].中外医学研究,2014,12(7):7-8.
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