血清降钙素原在心脏瓣膜置换术后呼吸机相关性肺炎防治中的应用价值研究  

Clinical study of serum procalcitonin in ventilator-associated pneumonia in patients with heart valve replacement surgery

作　　者：姜博[1] 李明亮[1] 李艳婷 宋艳艳[1] JIANG Bo;LI Mingliang;LI Yanting;SONG Yanyan(Department of Cardiovascular Surgery,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院心脏大血管外科,宁夏银川750004

出　　处：《宁夏医学杂志》2023年第6期508-510,共3页Ningxia Medical Journal

摘　　要：目的观察血清降钙素原(PCT)在心脏瓣膜置换术后水平变化,探讨其在心脏瓣膜置换术后呼吸机相关性肺炎(VAP)防治过程中的应用价值。方法选取行心脏瓣膜置换术患者共80例,术后诊断VAP 40例设为观察组,未诊断VAP 40例设为对照组,观察2组患者在术前(T0)、术后第1 d(T1)、术后第2 d(T2)、术后第3 d(T3)血清PCT、血白细胞计数、C-反应蛋白(CRP)的变化。排除术前感染及术后存在肺外器官感染,如手术切口、泌尿系统、深静脉置管、腹腔感染等的患者。结果血清PCT在观察组术后各点较术前明显升高,且高于对照组,差异均有统计学意义(P<0.05)。PCT在对照组术后比术前升高,差异有统计学意义(P<0.05),但在术后各点无明显变化,差异无统计学意义(P>0.05)。血白细胞计数与CRP在2组组内同术前比较均升高,差异有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05)。结论PCT对心脏瓣膜置换术后VAP有重要意义,可作为术后发生VAP的早期预测指标。Objective To observe the changes of serum procaleitonin(PCT)in perioperative period after cardiac valve replacement,and explore the value in ventilator-associated pneumonia(VAP)in patients with heart valve replacement surgery.Methods 80 patients undergoing heart valve replacement surgery were selected,with 40 patients diagnosed with VAP as the observation group and 40 patients without VAP as the control group.The changes of serum PCT,white blood cell count,C reactive protein(CRP)were observed at preoperative(T0).postoperative 1d(T1).postoperative 2d(T2).postoperative 3d(T3).Those patients with preoperative infection and postoperative infection of extrapulmonary organs,such as incision,urinary system,deep vein catheterization and abdominal cavity infection were excluded.Results The serum PCT were significantly increased after operation and were significantly higher in the observation group than the control group(P<0.05).The PCT were also increased in the control group after operation than preoperation(P<0.05),but there was no significant difference at different time after operation(P>0.05).While white blood cell count and CRP were increased before treatment in both group(P<0.05),but there was no significant difference between the two groups(P>0.05).Conclusion The serum PCT level is of great significance in the diangnosis of VAP after heart valve replacement surgery,and serum PCT can be used as an early predictor of VAP after heart valve replacement.

关 键 词：降钙素原 心脏瓣膜置换术 呼吸机相关性肺炎 围术期 

分 类 号：R473[医药卫生—护理学]