ICU中神经外科术后患者PCT监测的意义

Significance of PCT Monitoring in ICU Patients after Neurosurgery Operation

目的评价重症监护室中神经外科术后患者PCT监测在鉴别其发热原因中的作用。方法回顾性分析2013年1月~2015年12月笔者医院重症监护室收治的神经外科术后7天内出现发热的患者共102例,根据临床资料分为感染组及非感染组,比较两组患者炎性指标的变化及分析各种炎性指标与感染的关系。结果感染组年龄明显高于非感染组;感染组与非感染组炎性指标均高于正常值,感染组白细胞计数、中性粒细胞百分比及C反应蛋白均高于非感染组,但两组之间比较差异无统计学意义(P>0.05);感染组PCT水平(47.4±35.2ng/ml)明显高于非感染组(2.3±2.0ng/ml),两组之间比较差异有统计学意义(P>0.05)。感染组APACHE2评分明显高于非感染组;且PCT水平与APACHE2评分具有线性相关性。结论神经外科术后发热患者PCT水平均高于正常值,术后合并感染者PCT水平可明显升高。常规监测神经外科术后发热患者PCT水平对鉴别是否合并感染具有十分重要的价值,可更好地指导临床治疗,且PCT水平对患者的预后具有指导价值。

Objective To evaluate the role of PCT monitoring in the differential diagnosis of patients after neurosurgery operationin in ICU. Methods A total 102 patients after neurosurgery operationin within 7 days appear fever patients in our hospital ICU from January 2013 to December 2015 were done a retrospective analysis. According to their clinical data, they were divied to infection group and non infection group, to compared with the changes in inflammatory indicators and analysis their relationship with infection in two groups. Results The age in the infected group was significantly higher than non - infection group. Inflammatory markers in two groups were high- er than the normal value. White blood cell count, neutrophil percentage and C reactive protein in the infected group were higher than non infected group, but there was no significant difference between them. The serum PCT leve｜s of infected group （47.4 ＋ 35.2ng/ml） was significantly higher than non - infected group （2.3 ＋ 2.0ng/ml） , there was a significantly higher than non - infected group. APACHE2 score in infected group was significantly higher than non - infected group, and PCT was linearly correlated with APACHE2 score. Conclu- sion The PCT levels in patients after neurosurgery opcrationin were higher than normal. The level of PCT in postoperative complicating infection was significantly increased. Routine monitoring PCT levels,who was fever after neurosurgica[ postoperative, is of great value to identify whether they were complicating infection, to better guide clinical treatment, the level of PCT has a guiding value for prognosis.