动态监测血清CRP与PCT水平对预防急诊输液患者血流感染的意义  

Significance of dynamic monitoring of serum CRP and PCT levels on prevention of bloodstream infection in patients receiving emergency infusion

作　　者：颜红 王春英[2] 张蓓蕾[3] 顾庆香 杨玉艳 周春艳 

机构地区：[1]宁波市第二医院输液室,浙江宁波315000 [2]宁波市第二医院护理部,浙江宁波315000 [3]宁波市第二医院血透室,浙江宁波315000 [4]宁波市第二医院康复科,浙江宁波315000 [5]宁波市妇女儿童医院输液室,浙江宁波315000

出　　处：《中华医院感染学杂志》2018年第1期55-57,65,共4页Chinese Journal of Nosocomiology

摘　　要：目的动态监测血清C-反应蛋白(CRP)、降钙素原(PCT)水平对预防急诊输液患者并发血流感染的意义,为临床降低急诊输液患者发生血流感染提供新思路。方法选择2015年1月-2016年1月医院收治的124例急诊输液患者作为研究对象,根据就诊顺序编号,分为对照组和试验组,每组各62例;对照组采用常规临床路径管理输液过程预防血流感染,试验组患者在对照组基础上于入组后前3d每24h监测一次患者血清CRP和PCT指标水平,随后每3d监测1次,医师根据CRP和PCT动态监测结果调整血流感染预防方案。结果两组患者就诊时血清CRP、PCT比较差异无统计学意义;试验组患者入组一周内血清CRP、PCT出现较大的变化,以入组后24、48、72h较高,其中入组后48h达到最高,其后逐渐下降;试验组预防血流感染方案调整次数明显高于对照组(P<0.05);试验组患者2周内血流感染率低于对照组,但组间比较差异无统计学意义。结论对急诊输液患者行动态血清CRP和PCT监测,可早期发现血流感染并采取措施,在感染病情不严重时予以对症治疗,降低患者出现血流感染的概率,提高患者治疗效率。OBJECTIVE To observe the significance of dynamic monitoring of serum C-reactive protein （CRP） and （procalcitonin） PCT levels on prevention of bloodstream infection in patients receiving emergency infusion so as to provide new ideas for reduction of incidence of the bloodstream infection.METHODS A total of 124 patients who received emergency infusion in hospitals from Jan 2015 to Jan 2016 were recruited as the study objects and divided into the control group and the experimental group according to the serial number of treatment, with 62 cases in each group.The control group was treated with conventional clinical pathway for management of infusion process so as to prevent the bloodstream infection, while the experimental group, on basis of the treatment of the control group, was given the monitoring of serum CRP and PCT once every 24 hours in the first 3 days after enrollment, followed by the monitoring once every 3 days, and the doctors adjusted the programs for prevention of blood- stream infection based on the results of dynamic monitoring of the CRP and PCT.RESULTS There was no signifi- cant difference in the serum CRP or PCT between the two groups of patients at the time of treatment.The levels of serum CRP and PCT of the experimental group showed great changes within one week after enrollment, turned to be relatively high after the enrollment for 24, 48 and 72 hours, reached to the highest after the enrollment for 48 hours and then gradually reduced.The number of times of adjusting the programs for prevention of bloodstream in- fection was significantly greater in the experimental group than in the control group （P〈0.05）.The incidence rate of bloodstream infection of the experimental group was lower than that of the control group within 2 weeks, how-ever, there was no significant between-group difference.CONCLUSION The dynamic monitoring of serum CRP and PCT may facilitate the early diagnosis of bloodstream infections in the patients receiving the emergency infusion so as to take measures, condu

关 键 词：急诊输液 动态监测 血清C-反应蛋白 血清降钙素原 血流感染 

分 类 号：R181.3[医药卫生—流行病学]