颅脑动脉瘤患者术后抗感染治疗对降钙素原的影响  

Effects of anti infection treatment on procalcitonin in postoperative patients with intracranial aneurysm

作　　者：何书萍[1] 余云湖[1] 李颖[1] 郭建选[1] 郭晓霞[1] 陆冬梅[1] 

机构地区：[1]遵义市第一人民医院神经外科,贵州遵义536002

出　　处：《中华医院感染学杂志》2016年第19期4467-4469,共3页Chinese Journal of Nosocomiology

基　　金：贵州省卫生厅科学技术基金资助项目(Gzwkj2013-1-059)

摘　　要：目的探讨不同时间抗感染方案对颅脑动脉瘤患者术后降钙素原(PCT)变化及手术效果的影响,以期为合理使用抗菌药物,降低术后肺部感染发生率,提高手术治疗效果。方法选择医院2013年12月-2015年12月收治的颅脑动脉瘤患者88例,随机单盲取法分为观察组与对照组各44例,观察组于PCT≥0.5μg/L时即刻给予抗感染治疗,对照组明确为肺部感染后抗感染治疗,观察两组术后预防性抗感染治疗3d后PCT、C-反应蛋白(CRP)及白细胞计数(WBC)水平,两组抗感染治疗期间肺部感染及不良反应发生率。结果预防性抗感染3d及5d,两组患者炎性指标PCT、CRP及WBC对比,差异均无统计学差异;观察组于术后6d患者PCT≥0.5μg/L 28例、对照组29例,观察组患者给予抗菌药物治疗,对照组患者继续观察,术后7~8d均确诊为肺部感染,给予抗菌药物治疗,观察组术后8d各项炎性指标均高于同组术后6d(P<0.05),PCT低于对照组同期(P<0.05),术后10d低于术后6d及对照组同期(P<0.05);两组患者术后均有不同程度肺部感染,观察组患者发生肺部感染1例,对照组均发生肺部感染,两组患者肺部感染的发生,差异有统计学意义(χ2=33.52,P<0.05);观察组患者不良反应发生率10.71%低于对照组34.48%,差异有统计学意义(P<0.05)。结论抗感染治疗可降低术后肺部感染率、促使PCT等炎性因子降低,据PCT水平给予抗感染治疗,疗效更佳。OBJECTIVE To investigate the effects of different anti infection methods at different time points on changes of procalcitonin（PCT）and surgical effect in postoperative patients with intracranial aneurysms,so as to rationally use of antibiotics,reduce the incidence of postoperative pulmonary infection,and improve the effect of surgical treatment.METHODS A total of 88 cases cerebral aneurysm patients in the hospital from Dec.2013 to Dec.2015 were selected,and divided into observation group and control group by randomized,single blind extraction method,with 44 cases in each group.In observation group,the patients were immediately treated with anti infection when PCT≥0.5μg/L,while in control group,anti-infection treatment were carried out after identifying as lung infection.The PCT,CRP and WBC levels of the two groups 3dafter anti-infection treatment were observed,and the pulmonary infection and adverse reactions during the treatment period were compared.RESULTS Prophylactic anti-infection 3dand 5d,there was no significant difference in the two groups of arthritis index of PCT,CRP and WBC.There were 28 cases of patients with PCT≥0.5μg/L in observation group in postoperative6 d,and 29 cases in control group.The patients in observation group were given antibiotic treatment,and in control group were continue to observe and were diagnosed of pulmonary infection postoperative 7d^8dand given antibiotics anti-infection treatment.The inflammatory indicators of observation group after 8days were higher than those of the operation in the same group after 6days（P〈0.05）,PCT was lower than that of control group at the same time（P〈0.05）,and postoperative 10 days were less than 6days after operation and compared with control group（P〈0.05）.Pulmonary infection was occurred in both groups after treatment.There was only 1case of pulmonary infection occurred in observation group,and 44 cases in control group,with significant difference（χ2=33.52,P〈0.05）.The treatment related adverse reaction rate of obse

关 键 词：颅脑动脉瘤患者术后 肺部感染 抗感染 降钙素原 手术效果 

分 类 号：R739.41[医药卫生—肿瘤]