目的：探讨雾化吸入阿米卡星治疗多重耐药铜绿假单胞菌呼吸机相关肺炎的效果。方法选取2013年3月~2015年3月于辽宁省大连市第二人民医院治疗的多重耐药铜绿假单胞菌呼吸机相关肺炎患者40例，分为实验组和对照组，各20例。两组均采用头孢哌酮舒巴坦静脉输注治疗，对照组联合阿米卡星静脉输注，实验组联合阿米卡星雾化吸入。两组患者均治疗7d。比较两组治疗效果、感染情况、肾功能及不良反应情况。结果实验组患者的临床好转率为85.0%，对照组为65.0%，两组比较差异有统计学意义(P<0.05)。两组治疗后PCT、CRP水平及CPIS均较治疗前降低(P<0.05)，实验组治疗后降低水平更明显(P<0.05)。两组治疗前后Scr及Cys C水平组间及组内比较，差异均无统计学意义(P>0.05)。实验组不良反应发生率低于对照组，差异有统计学意义(P<0.05)。结论阿米卡星雾化吸入治疗多重耐药铜绿假单胞菌呼吸机相关肺炎的效果较好，在相同剂量条件下，安全性更好。%Objective To explore effect of inhalation of Amikacin in the treatment of ventilator-associated pneumonia (VAP) induced by multiple-drug resistant Pseudomonas aeruginosa. Methods 40 cases of patients with VAP induced by multiple drug resistant Pseudomonas aeruginosa treated in the Second People's Hospital of Dalian City in Liaoning Province from March 2013 to March 2015 were selected and divided into experimental group and control group, with 20 cases in each group. All patients were treated with Cefoperazone sulbactam intravenously, control group was com-bined with Amikacin sulfate intravenous infusion, while experimental group was combined with inhalation of Amikacin. All patients were treated for 7 days. Treatment effect, infection station, renal function and adverse reaction were com-pared between two groups. Results Clinical improvement rate in experimental group and control group was 85.0% and 65.0% respectively, with statistically significant difference (P < 0.05). After treatment, the levels of PCT, CRP and CPIS in two groups were all significantly reduced (P < 0.05), experimental group decreased more significantly than control group (P<0.05). There was no significant difference in levels of Scr and Cys C between two groups before and after treatment (P>0.05). The incidence rate of adverse reaction in experimental group was lower than that in control group, with statistically significant difference (P<0.05). Conclusion The effect of inhalation of Amikacin in the treat-ment of VAP induced by multiple drug resistant Pseudomonas aeruginosa is better, and safer with the same dose.
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