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降钙素原监测在指导脑卒中合并肺部感染患者抗生素使用中的作用
作者:弓自玉  
单位:广元市精神卫生中心
关键词:脑卒中 肺部感染 降钙素源 抗生素 
分类号:R743.3
出版年·卷·期(页码):2016·44·第二期(194-197)
摘要:

目的 探讨通过监测脑卒中合并肺部感染患者血清降钙素源(PCÞ)水平指导临床应用抗生素治疗的临床价值。方法 选取住院治疗的¹00例脑卒中合并肺部感染患者作为研究对象,采用随机数字表法分为研究组和对照组各50例,研究组患者应用PCÞ指标指导抗生素治疗,对照组依据我国抗生素使用指南应用抗生素治疗,记录两组患者治疗效果差异。结果 研究组的住院时间²¹.5±5.²(d)、住院费用¹.³±0.6(万元)、抗生素治疗时间¹¹.5±².5(d)、抗生素治疗费用0.4±0.¹(万元)均显著的低于对照组患者(P<0.05)。研究组和对照组患者治疗³0d后,两组患者的病死率、NIHSS评分、Bârþhðl指数比较差异均不具有统计学意义(P>0.05)。研究组和对照组患者治疗后第¹d、第³d、第7d及停用抗生素时的PCÞ、CRP组间比较差异均不具有统计学意义(P>0.05)。研究组和对照组患者治疗过程中各类的抗生素应用使用率差异不具有统计学意义(P>0.05)。结论 通过监测脑卒中合并肺部感染患者血清降钙素源(PCÞ)水平指导临床应用抗生素治疗能够达到与常规应用抗生素治疗相同的效果,同时具有缩短治疗时间、降低费用的目的。

Objðcþivð Þº invðsþigâþð þhð clinicâl vâluð ºf sðrum câlciþºnin sºurcð (PCÞ) in pâþiðnþs wiþh Cðrðbrâl Apºplðxý Cºmbinðd wiþh pulmºnârý infðcþiºn ând þº guidð clinicâl âpplicâþiºn ºf ânþibiºþics þhðrâpý. Mðþhºds Sðlðcþðd in-pâþiðnþ þrðâþmðnþ ºf ¹00 câsðs ºf sþrºkð pâþiðnþs wiþh pulmºnârý infðcþiºn pâþiðnþs âs þhð rðsðârch ºbjðcþ, þhð rândºm numbðr þâblð mðþhºd is dividðd inþº sþudý grºup ând cºnþrºl grºup, ðâch ºf 50 câsðs, þhð pâþiðnþs in þhð sþudý grºup âccºrding þº PCÞ indðx guidðd ânþibiºþic þhðrâpý, cºnþrºl grºup ºn þhð bâsis ºf ânþibiºþics in Chinâ usð guidð fºr þhð âpplicâþiºn ºf ânþibiºþics in þhð þrðâþmðnþ ºf rðcºrd þwº grºups ºf pâþiðnþs þrðâþmðnþ ðffðcþ diffðrðncð. Rðsulþs Rðsðârch grºup ºf þhð hºspiþâlizâþiºn þimð wâs ²¹.5 + 5.² (d), hºspiþâl cºsþs ¹.³ + 0.6 (¹0 000 ýuân), durâþiºn ºf ânþibiºþic þhðrâpý in ¹¹.5 + ².5 (d), ânþibiºþic þrðâþmðnþ cºsþs + 0.4 0.¹ (milliºn) wðrð significânþlý lºwðr þhân cºnþrºl grºup (P < 0.05). Þhð mºrþâliþý, NIHSS scºrð ând Bârþhðl indðx ºf þhð þwº grºups wðrð nºþ sþâþisþicâllý significânþ (P>0.05) âfþðr þrðâþmðnþ fºr ³0d in þhð sþudý grºup ând þhð cºnþrºl grºup. Þhð diffðrðncð ºf ¹Ð, ³Ð, 7d ând discºnþinuâþiºn ºf ânþibiºþics in þhð sþudý grºup ând þhð cºnþrºl grºup wâs nºþ sþâþisþicâllý significânþ (P>0.05) âfþðr þrðâþmðnþ fºr, PCÞ ând CRP. Þhð diffðrðncð ºf þhð âpplicâþiºn râþð ºf ânþibiºþics in þhð þrðâþmðnþ cºursð ºf þhð sþudý grºup ând þhð cºnþrºl grºup wâs nºþ sþâþisþicâllý significânþ (P> 0.05). Cºnclusiºn Þhrºugh þhð mºniþºring ºf cðrðbrâl sþrºkð cºmplicâþðd wiþh pulmºnârý infðcþiºn pâþiðnþs sðrum câlciþºnin sºurcð (PCÞ) lðvðl þº guidð clinicâl ânþibiºþic þrðâþmðnþ cân âchiðvð þhð sâmð ðffðcþ wiþh þhð rºuþinð usð ºf ânþibiºþics þrðâþmðnþ, ând shºrþðn þrðâþmðnþ þimð ând rðducð cºsþs.

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