动态监测降钙素原对重症颅脑损伤开颅患者术后感染早期诊断价值分析

目的探讨血清降钙素原(PCT)及其动态变化监测对于重症颅脑损伤患者开颅手术后早期诊断价值及预后预测价值.方法选取126例重症颅脑损伤并行开颅手术后患者,于不同时间点分别留取各个患者的血标本,并收集患者临床资料,根据有无感染分为感染组59例和未感染组67例.比较两组不同时间内体温峰值、白细胞计数、中性粒细胞百分数以及PCT等指标,分析PCT早期监测感染发生情况,并指导预后评估.结果感染组血清PCT水平每个时段均高于对照组,差异具有统计学意义(P0.05);此外,5例重症感染患者中有2例死亡,且PCT水平持续增高,而3例存活患者PCT水平随着临床症状的改善呈下降趋势.血清PCT与重症颅脑损伤患者开颅术后院内感染呈正相关.结论血清PCT在感染早期即可出现异常改变,并可在一定程度上反映患者的病情危重程度,参与预后评估.

Clinical Significance of Dynamic Determination of Serum Procalcitonin Levels in Judgment of Nosocomial Infection in Patients with Traumatic Brain Injury

ObjectiveTo explore the clinical significance of dynamic determination of serum procalcitonin(PCT) levels in the judgment of nosocomial infection and prognosis in patients with traumatic brain injury.MethodA total of 126 patients with traumatic brain injury after craniotomy were selected and divided into infection group and non-infection group.The temperature,serum white blood cell count (WBC),neutrophil (N) and PCT were compared between infection group and non-infection group.The relation between dynamic serum PCT level change and prognosis was studied.ResultsThe level of serum PCT in infection group was higher than that in non-infection group and there was significant difference (P<0.05).5 patients with severe infection,2 patients were dead with the level of serum PCT sustained increase,while 3 survived patients with the level of serum PCT decrease.ConclusionThe alteration of serum PCT level may be used as one of the effective predictors for the nosocomial infection in patients with traumatic brain injury.