摘要
目的评价血清降钙素原(PCT)水平监测对指导儿童重症监护病房(PICU)医院感染抗菌药物应用的临床意义,以指导临床合理使用抗菌药物,减少耐药菌的产生。方法将147例PICU医院感染患儿分为对照组(67例)与观察组(80例),两组患儿常规行白细胞计数(WBC)、C反应蛋白(CRP)水平测定,据患儿症状必要时行血培养、痰培养及大便轮状病毒抗原等检查,观察组同时行血清PCT水平测定,对阳性患儿予以抗菌药物治疗,比较两组患儿抗菌药物使用率、疗效及PICU住院时间。结果两组患儿医院感染发病率及疾病构成比比较差异无统计学意义,观察组57例患儿检测血清PCT≥0.5ng/ml,给予抗菌药物治疗,使用率为71.3%,对照组62例患儿使用抗菌药物治疗,使用率为92.5%,差异有统计学意义(P<0.01);两组患儿疗效,治愈率、好转率、死亡率及PICU住院时间比较差异无统计学意义。结论对PICU医院感染患儿进行血清PCT水平监测鉴别诊断细菌感染与非细菌感染,指导临床合理使用抗菌药物,降低抗菌药物使用率,减少耐药菌的产生。
OBJECTIVE To evaluate the clinical significance of procalcitonin（PCT） monitoring in guiding the use of antibiotics for the nosocomial infections in pediatric intensive care unit（PICU） so as to reduce the drug resistant strains.METHODS A total of 147 patients who were hospitalized in pediatric intensive care unit were divided into the control group（n=67） and the observation group（n=80）.All patients were measured the C-reactive protein（CRP） level and WBC count.The blood cultures,sputum cultures,stool cultures and detection of rotavirus antigen of stool were performed according to their symptoms.The serum PCT level of the observation group was determined,and the patients with the positive outcomes were treated with antibiotics.The utilization rate,therapeutic effect,and stay in the PICU of the two groups were compared.RESULTS There was no statistical difference in the incidence of nosocomial infections and the constituent ratio of disease between the two groups.The PCT level of 57 children in the observation group was over 0.5 ng/ml,and the utilization rate of the antibiotics for treatment was 71.3%,while there were 62 children in the control group who used antibiotics for treatment with the utilization rate of 92.5%,the difference was statistically significant.The differences in the therapeutic effect,cure rate,recovery rate,mortality,and the stay in PICU between the two groups were not statistically significant.CONCLUSION The PCT level can be used to distinguish between the bacterial infections and non-bacterial infections,to guide the reasonable use of antibiotics,to reduce the utilization rate of antibiotics,and prevent the emergence of drug resistant bacteria.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第4期752-753,756,共3页
Chinese Journal of Nosocomiology
关键词
降钙素原
儿童重症监护病房
医院感染
抗菌药物
Procalcitonin
Pediatric intensive care unit
Nosocomial infection
Antibiotics
