血清降钙素原水平监测在老年重症肺炎支气管肺泡灌洗中的应用分析

Application Analysis of Serum Procalcitonin Level Monitoring in Bronchoalveolar Lavage in Elderly Patients with Severe Pneumonia

目的:分析支气管肺泡灌洗液血清降钙素原(PCT)优化老年重症肺炎患者抗菌药物治疗方案。方法:择取2020年1月-2021年12月佛山市中医院呼吸科及重症医学科收治的老年重症肺炎患者60例为观察对象,根据随机数表法分成对照组及观察组,各30例。对照组予以常规抗感染、支气管肺泡灌洗治疗方案,观察组予以常规抗感染方案、支气管肺泡灌洗联合基于PCT水平的用药指导方案,对比两组抗菌药物使用情况、住院时间与预后情况。结果:观察组抗菌药物使用时间、使用种类数均低于对照组,差异有统计学意义(P<0.05);观察组住院时间短于对照组,差异有统计学意义(P<0.05);观察组转出ICU率高于对照组,差异有统计学意义(P<0.05);两组死亡率比较,差异无统计学意义(P>0.05)。结论:采取血清降钙素原水平监测方案优化老年重症肺炎患者支气管肺泡灌洗,能够缩短抗菌药物使用时间及住院时间,减少抗菌药物的使用,可改善预后。

Objective:To analyze the serum procalcitonin(PCT)level monitoring in bronchoalveolar lavage to optimize the antibiotic treatment plan in elderly patients with severe pneumonia.Methods:A total of 60 elderly patients with severe pneumonia who were admitted to the Foshan Hospital of Traditional Chinese Medicine and the Department of Critical Care Medicine from January 2020 to December 2021 were selected as the observation objects.According to the random number table method,they were divided into control group and observation group,30 cases in each.The control group was given routine anti-infection and bronchoalveolar lavage treatment regimen,while the observation group was given routine anti-infection regimen,bronchoalveolar lavage combined with medication guidance based on PCT level.The use of antibiotics,hospital stay and prognosis were compared between the two groups.Results:The use time and types of antibiotics in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).The length of hospital stay in the observation group was shorter than that in the control group,and the difference was statistically significant(P<0.05).The rate of being transferred out of the ICU in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in mortality between the two groups(P>0.05).Conclusion:The use of serum procalcitonin level monitoring program to optimize bronchoalveolar lavage in elderly patients with severe pneumonia can shorten the duration of antibiotic use and hospital stay,can reduce the use of antibiotics and can improve prognosis.