不同术式治疗脑脓肿患者后C-反应蛋白与血清降钙素原及相关感染指标的水平变化及疗效分析  

Changes of levels of C-reactive protein,serum procalcitonin and infection-related indexes of brain abscess patients after different surgical procedures and efficacy analysis

作　　者：李庆志[1] 王鹏程[1] 黄垂学[1] 陈宝智[1] 赵建农[1] 

机构地区：[1]海南省人民医院神经外科,海南海口570103

出　　处：《中华医院感染学杂志》2017年第21期4919-4922,共4页Chinese Journal of Nosocomiology

基　　金：海南省自然科学基金资助项目(30852)

摘　　要：目的分析CT定位穿刺引流术与开颅手术治疗患者脑脓肿后C-反应蛋白(CRP)、血清降钙素原(PCT)和相关感染指标水平变化及治疗效果研究。方法选取2011年4月-2016年12月医院治疗的脑脓肿患者93例,根据治疗术式不同分两组,其中对照组45例患者采用开颅清除术;试验组48例患者采用CT定位穿刺引流术治疗,比较两组患者在治疗前后的CRP、PCT水平、血液WBC、脑脊液WBC和脑脊液蛋白(CSFT)的变化以及治疗效果。结果试验组患者术后CRP为(57.29±10.38)mg/L、PCT为(0.28±0.14)ug/L明显低于对照组的CRP的(111.34±12.65)mg/L、PCT(2.94±0.47)ug/L;术后试验组的血液WBC为(9.83±1.32)×109/L、脑脊液WBC为(7.56±0.29)×106/L、脑脊液蛋白为(CSFT)(185.47±26.64)mg/L显著优于对照组;术后试验组患者的治疗有效率为97.92%明显高于对照组的84.44%,而脓肿复发率为2.08%、并发症发生率为4.17%明显低于对照组的15.56%、11.11%;以上数据两组比较差异均有统计学意义(P<0.05)。结论 CT定位穿刺引流术对脑脓肿患者的CRP、PCT、WBC和CSF各项指标水平有显著改善作用,对脓肿清除效果明显优于开颅手术且并发症发生率较低,是一种治疗效果明确的理想术式。OBJECTIVE To investigate the changes of levels of C-reactive protein（CRP）and serum procalcitonin（PCT）as well as infection-related indexes of brain abscess patients after CT-targeted drainage and craniotomy and observe the therapeutic effects.METHODS A total of 93 brain abscess patients who were treated in the hospital from Apr.2011 to Dec.2016 were enrolled in the study and were divided into two groups according to the surgical treatment procedures.Control group with 45 cases was treated with craniotomy,and observation group with 48 cases was given CT-targeted drainage.The levels of CRP,PCT,blood WBC,cerebrospinal fluid WBC and cerebrospinal fluid protein（CSFP）were compared between the two groups of patients before and after the treatment,and the therapeutic effects were observed.RESULTS The postoperative CRP and PCT levels of observation group were（57.29±10.38）mg/L and（0.28±0.14）ug/L,which were significantly lower than（111.34±12.65）mg/L and（2.94±0.47）ug/L of control group.The postoperative blood WBC counts,cerebrospinal fluid WBC counts and CSFP level of observation group were（9.83±1.32）×10^9/L,（7.56±0.29）×10^6/L and（185.47±26.64）mg/L,which were significantly better than those of control group.After the surgical procedures,the effective rate of observation group was 97.92%,which was significantly higher than 84.44% of control group,and the recurrence rate of abscess and incidence of complications of observation group were 2.08% and 4.17%,which were significantly lower than 15.56% and 11.11% of control group（P〈0.05）.CONCLUSIONThe CT-targeted drainage may remarkably improve the levels of CRP,PCT,WBC and CSF indexes of the brain abscess patients and can achieve significantly effect on clearance of abscess than the craniotomy,and it is an ideal surgical procedure that can achieve definite therapeutic effect.

关 键 词：脑脓肿 CT定位引流术 开颅手术 感染指标 治疗效果 

分 类 号：R619.3[医药卫生—外科学]