摘要
目的对早期应用血清降钙素原诊断脑损伤患者辅助呼吸机并发肺炎进行分析并观察其临床疗效。方法选取泰州市第二人民医院在2015年2月—2017年2月期间重症监护室(ICU)收治的脑损伤并使用呼吸机的患者行机械通气进行治疗,选择第1～4天发生肺炎的患者32例作为观察组,未发生肺炎的32例作为对照组,分别于行机械通气前以及机械通气第4天检测血清降钙素原(PCT)水平,以及患者C-反应蛋白(CRP)、白细胞(WBC)、体温情况,对观察组的灵敏度及特异度进行评价,并且对2组预后情况进行分析。结果与通气前比较,观察组机械通气后各项指标均上升(P<0.05)。机械通气后观察组PCT、CRP和WBC与对照组比较均升高,差异有统计学意义(P<0.05);体温亦升高,但差异无统计学意义(P>0.05)。观察组CRP诊断结果灵敏度高、特异度低,PCT对灵敏度以及特异度进行诊断的结果均较高。观察组预后机械通气、ICU驻留、住院的时间均比对照组长,差异有统计学意义(P<0.05)。结论早期应用血清降钙素原诊断脑损伤患者辅助呼吸机并发肺炎的效果好,有很好的应用价值。
Objective To analyze the clinical effect of early application of procalcitonin in the diagnosis of pneumonia caused by auxiliary ventilators in patients with brain injury. Methods Between February 2015 and February 2017, 32 patients with brain injury and ventilator-induced pneumonia on day 1-4 were selected as the observation group while another 32 patients without pneumonia served as the control group. Serum PCT levels, CRP, WBC and body temperature were measured before mechanical ventilation and 4 days later. The sensitivity and specificity of the observation group were evaluated, and the prognosis of the two groups was analyzed. Results Compared with before ventilation, the indexes of observation group increased after mechanical ventilation (P<0.05). After mechanical ventilation, the indexes (PCT, CRP, WBC) in the observation group were significantly higher (P<0.05) than those in the control group, the body temperature was also elevated, but the difference was not significant (P>0.05). Despite the high sensitivity of CRP in the observation group, its specificity was relatively low, whereas both the sensitivity and specificity of PCT were quite high. The duration of mechanical ventilation, ICU stay and hospitalization in the observation group were significantly longer than those in the control group (P<0.05). Conclusion Early application of serum procalcitonin in the diagnosis of pneumonia caused by auxiliary ventilators in patients with brain injury is effective and worthy of application.
作者
石志祥
李敏
马才林
潘怀富
沈剑虹
SHI Zhixiang;LI Min;MA Cailin;PAN Huaifu;SHEN Jianhong(Critical Care Medicine, Taizhou Second People's Hospital, TaizhouJiangsu 225500, China)
出处
《空军医学杂志》
2019年第1期32-34,共3页
Medical Journal of Air Force
