血清降钙素原与白细胞计数、C反应蛋白对外科手术患者的临床诊断价值分析  

Analysis of Serum Procalcitonin and the White Blood Cell Count, C-reactive Protein in Patients with Surgical Clinical Diagnostic Value

作　　者：冯锡[1] 

机构地区：[1]邻水县人民医院,四川邻水638500

出　　处：《中外医学研究》2016年第31期10-12,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:根据外科手术患者切口分类,探讨其血清降钙素原(PCT)、白细胞计数(WBC)和C反应蛋白(CRP)的临床诊断价值,及时判断患者细菌性感染程度,正确指导临床合理应用抗生素。方法:收集2015年1-12月笔者所在医院外科手术患者579例的PCT、WBC、CRP数值,根据外科手术患者切口分类分组,判断其细菌感染严重程度,找出其相关性,评价其临床诊断价值。结果:患者手术切口分类Ⅲ组的PCT、WBC、CRP数值均高于Ⅰ组和Ⅱ组,差异有统计学意义(P<0.05)。WBC计数阳性率Ⅲ组(93.8%)与Ⅰ组(90.9%)、Ⅱ组(95.3%)比较差异无统计学意义(P>0.05)。CRP阳性率Ⅲ组(81.5%)与Ⅰ组(78.8%)、Ⅱ组(78.2%)比较差异无统计学意义(P>0.05)。PCT阳性率Ⅲ组最高(100%),明显高于Ⅰ组(19.4%)和Ⅱ组(69.9%),差异有统计学意义(P<0.01)。结论:外科手术患者细菌性感染程度与手术切口分类有一定关系,分类级别越高,细菌性感染越严重。手术患者PCT、WBC、CRP数值一般会增高,但是PCT与细菌性感染程度相关性更强、特异性更高。因此针对外科手术患者检测PCT能直接指导临床合理应用抗生素,比WBC、CRP的临床诊断价值要高。Objective：To investigate the clinical diagnostic value of the serum Procalcitonin（PCT）,white blood cell count（WBC） and c-reactive protein（CRP）,according to the classification of surgical patients,to judge the degree of bacterial infection in patients with, to guide clinical rational use of antibiotics.Method：579 patients with PCT, WBC,CRP data were collected from January 2015 to December in the author＇s hospital,grouped according to the classification of surgical patients,the severity of bacterial infection was determined,its relevance was found out,its clinical diagnostic value was evaluated.Result：Classification of patients with incision group Ⅲ PCT,WBC,CRP values were higher than that of groupⅠand groupⅡ, the difference was statistically significant（P〈0.05）. The WBC count positive of group Ⅲ（93.8%） and groupⅠ（90.9%）,groupⅡ（95.3%） was no statistically significant difference（P〈0.05）. CRP positive of group Ⅲ（81.5%） and groupⅠ（78.8%）,groupⅡ（78.2%） was no statistically significant difference（P〈0.05）. PCT positive group Ⅲ（100%） was significantly higher than that of groupⅠ（19.4%） and groupⅡ（69.9%）,the difference was statistically significant（P〈0.01）.Conclusion：Bacterial infections in patients with surgical incisions and the degree of classification have a certain relationship,the higher classification level,the more serious bacterial infections.Patients with PCT, WBC,CRP values tend to increase,but the correlation between PCT and the degree of bacterial infections is stronger, and the specificity is higher.So in view of the surgical patients to detect PCT can directly guide clinical rational use of antibiotics,and higher than the clinical diagnosis value of WBC and CRP.

关 键 词：手术切口分类 细菌性感染程度 降钙素原 白细胞计数 C反应蛋白 

分 类 号：R61[医药卫生—外科学]