在新生儿呼吸机相关性肺炎抗生素治疗中的应用

Value of detection of serum procalcitonin in guidance of antibiotic therapy of neonatal ventilator associated pneumonia

目的探讨血清降钙素原(PCT)检测在新生儿呼吸机相关性肺炎(VAP)治疗中对抗菌药物使用的指导意义。方法选取56例新生儿呼吸机相关性肺炎患儿随机分成两组:PCT组30例,对照组26例,PCT组根据血清PCT检测水平来判断抗生素的使用;常规组根据患者血CRP、X线胸片、痰培养以及其他实验室检查判断抗生素的使用。观察两组新生儿的抗生素使用时间、使用率、住院时间、死亡率等。结果 PCT组的抗生素使用时间为(9.5±1.9)d,对照组为(11.8±2.1)d,两组差异有统计学意义(t=4.3,P=0.0001);两组的抗生素使用率、住院时间、死亡率及再发率差异无统计学意义(P>0.05)。结论 PCT可有效指导新生儿呼吸机相关性肺炎的抗生素治疗,明显缩短抗生素使用时间,减少抗生素暴露。

Objective To assess the value of detection ofserum procalcitonin（PCT） in guidance of use of antibiotics forthe treatment of neonatal ventilator associated pneumonia（VAP）. Methods The 56 neonatal ventilator associated pneumoniacases were randomly divided into PCT group（n=30） and the control group（n=26）, The use of antibiotics in cases in PCT groupwas determined according to the serum PCT levels, while the use of antibiotics in cases of control group was determinedaccording to the parameters of patients’ blood CRP, X-ray chest radiograph, sputum culture and other laboratory examinationThe time of antibiotics use, rate, duration of hospitalization and death rate,etc. in the two groups were analyzed. Results Thetime of antibiotics use was shorter in the control group than in of the PCT group, showing significant difference[（9.5±1.9） d vs（11.8±2.1）d, t =4.3, P =0.0001]. There was no statistically significant difference in antibiotics usage, duration of hospitalizationand death rate between the PCT group and the control group（P 〉0.05）. Conclusion The PCT can be used for effectiveguidance of treatment of neonatal ventilator associated pneumonia with antibiotics and leading to shortening time of antibioticsuse and reducing exposure time.