监测血清降钙素原对骨折手术感染抗菌药物应用影响分析  

Clinical significance of monitoring of serum procalcitonin in use of antibiotics for fracture patients with postoperative infections

作　　者：杨洪平[1] 白玉树[2] 李明[2] 

机构地区：[1]武汉科技大学附属天佑医院骨科,湖北武汉430064 [2]第二军医大学附属长海医院骨科,上海200433

出　　处：《中华医院感染学杂志》2015年第1期14-15,30,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81101396)

摘　　要：目的探讨骨折手术感染患者应用血清降钙素原(PCT)检测指导抗菌药物使用的临床意义,为抗菌药物应用提供参考依据。方法选取2012年2月-2014年2月204例骨折手术后感染患者,随机分为普通组与治疗组,各102例,普通组常规应用抗菌药物治疗,治疗组在治疗过程中检测PCT,根据PCT改变实施抗菌药物方案,对比两组抗菌药物使用时间、剂量及炎性反应指标。结果治疗组患者抗菌药物使用时间(4.39±1.59)d、费用(1 032.54±128.43)元及住院时间(7.49±2.11)d均少于普通组,对比差异有统计学意义(t=5.394、8.493、7.194;P<0.05);治疗组治疗后IL-6为(31.64±9.65)ng/L、CRP为(5.34±2.46)μg/L、白细胞指数为(13.65±6.32)×109/L,均低于普通组,对比差异有统计学意义(t=8.232、6.403、7.432;P<0.05)。结论根据PCT检测结果实时改变抗菌药物使用方法,可有效减少抗菌药物滥用,提升治疗效果。OBJECTIVE To explore the clinical significance of detection of serum procalcitonin （PCT）in the fracture patients with postoperative infections so as to provide guidance for use of antibiotics.METHODS A total of 204 fracture patients with postoperative infections who were treated from Feb 2012 to Feb 2014 were enrolled in the study and randomly divided into the common group and the treatment group;the common group was given the conventional drug therapy,while the treatment group was treated with antibiotics based on the change of the PCT level;the time of use of antibiotics,dosage,and inflammatory reactions indicators were observed and compared between the two groups.RESULTS The time of use of antibiotics of the treatment group was （4.39±1.59）days, the cost of antibiotics （1032.54±128.43）yuan,the length of hospital stay （7.49±2.11）days,less than those of the common group,there was significant difference （t=5.394,8.493,7.194;P〈0.05）.After the treatment, the IL-6 level of the treatment group was （31.64±9.65）ng/L,the CRP level （5.34±2.46）μg/L,the white blood cells counts （13.65±6.32）×10^9/L,lower than those of the common group,there was significant differ-ence （t=8.232,6.403,7.432;P〈0.05）.CONCLUSION It is an effective way to use the antibiotics based on the results of monitoring of PCT so as to reduce the abuse of antibiotics and raise the curative effect.

关 键 词：血清降钙素原 骨折 感染 抗菌药物 

分 类 号：R446[医药卫生—诊断学]