降钙素原监测在老年烧伤患者抗感染治疗中的临床意义  

Clinical significance of pro-calcitonin monitoring guiding anti-infective therapy for the elderly burn patients

作　　者：赵海春 肖荣 胡东升 王国亮 林国安 

机构地区：[1]解放军159医院体检中心,河南驻马店463000 [2]解放军159医院烧伤科,河南驻马店463000

出　　处：《实用医药杂志》2017年第7期603-605,共3页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨降钙素原(pro-calcitonin,PCT)监测对老年烧伤患者抗感染治疗的临床意义。方法回顾性分析笔者所在医院近3年收治烧伤面积在50%以下、Ⅲ度面积在30%以下、不合并吸入性损伤的193例老年烧伤患者,按PCT不同水平统计分析其抗生素使用、创面细菌培养、血细菌培养、手术治疗及预后情况。结果 PCT水平越高,对应抗生素治疗档次越高;血细菌培养阳性率与PCT水平相关(P=0.007),病死率与PCT水平相关(P=0.004);创面细菌培养阳性率、手术治疗率与PCT水平不相关(P>0.05)。结论 PCT监测是评估老烧伤患者感染严重程度、转归与预后的良好指标,对合理应用抗生素、及时采取措施控制初期感染及判断预后具有重要指导作用。Objective To investigate the effects of pro-calcitonin（PCT） monitoring on anti-infective therapy for the elderly bums. Methods One hundred and ninety-three elderly burn patients were enrolled in this study, who were below 50% of total body surface area （TBSA） and three degree burns below 30% TBSA,further more, but without inhalation injury. According to the serum level of PCT,they were divided into 5 groups in order to that the cultivation of wound and blood bacteria,antibiotic treatments,surgeries,and outcomings of the patients were retrospectively analyzed. Results Increasing PCT level leaded to the administration of higher grade of antibiotics;Positive rate of blood culture and mortality were correlated with serum PCT level （P〈0.01）;while positive rate of wound culture and surgery rate are not （P〉0.05）. Conclusion Serum PCT level is a sensitive marker for the assessment of infection in elderly bums,guiding a rational use of antibiotics,control of initial infection, and accurate prognosis.

关 键 词：降钙素原 老年烧伤 抗感染治疗 创面脓毒症 

分 类 号：R644[医药卫生—外科学]