颅底骨折合并颅内感染患者血清降钙素原的变化

发布时间：2018-08-29 18:18

【摘要】：目的:观察颅底骨折合并颅内感染患者中血清降钙素原(PCT)的水平及其变化,探讨血清PCT值在颅底骨折合并颅内感染患者早期诊断中的作用。方法:运用酶联荧光分析法(ELFA法)测定30例颅底骨折住院期间经保守治疗的患者。出院时根据颅内感染的诊断结果,将其分为感染组(n=15)和非感染组(n=15)。设定伤后第1天为(T1)、第2天为(T2)、第3天为(T3)、感染组确诊颅内感染时间与未感染组相同时间为(T4),出院时间为(T5),五个时间段取血样测定的血液常规检测、血清PCT值。对比分析不同时间点的血清PCT浓度、血液各项检测指标。待颅底骨折患者耳鼻无漏液时,行腰椎穿刺术取脑脊液检测脑脊液常规、生化,脑脊液PCT值及行脑脊液细菌培养。探讨血清PCT值在颅底骨折合并颅内感染患者中的早期诊断的作用。结果:1.颅底骨折患者中,T1感染组血清PCT值大于对照组,差异有显著性;未感染组与对照组血清PCT值无统计学意义。T2、T3、T4感染组、未感染组血清PCT值均大于对照组,差异有显著性。T2、T3、T4感染组血清PCT值均大于未感染组,差异有显著性;T5三组血清PCT值无统计学意义。2.T4感染组血液WBC值、NEU%、体温℃均大于未感染组,差异有显著性。3.以血清PCT≥0.185ng/m L为阳性阈值,对颅底骨折合并颅内感染的诊断灵敏度为93.3%,特异度86.7%。结论:颅底骨折可引起血清PCT值升高;颅底骨折合并颅内感染患者中,动态观察血清PCT可以早期发现颅内感染,血清PCT可以作为早期诊断的参考指标。
[Abstract]:Objective: to observe the level and change of serum procalcitonin (PCT) in patients with skull base fracture complicated with intracranial infection, and to explore the role of serum PCT in early diagnosis of skull base fracture with intracranial infection. Methods: 30 patients with skull base fracture were treated conservatively by enzyme linked fluorescence assay (ELFA). According to the diagnostic results of intracranial infection, the patients were divided into two groups: the infected group (nong15) and the non-infective group (nong15). The first day, the second day and the third day after injury were set as T1, T2 and T3, respectively. The time of confirmed intracranial infection in the infected group was the same as that in the non-infected group (T4), and the discharge time was (T5). The serum PCT concentration and blood indexes were compared and analyzed at different time points. When there was no fluid leakage in the ear and nose of the patients with skull base fracture, cerebrospinal fluid (CSF) routine, biochemistry, cerebrospinal fluid (PCT) value and cerebrospinal fluid (CSF) bacterial culture were detected by lumbar puncture. To investigate the value of serum PCT in the early diagnosis of skull base fracture with intracranial infection. The result is 1: 1. The serum PCT value of T1-infected group was higher than that of control group, and the serum PCT value of non-infected group and control group had no statistical significance. The serum PCT value of non-infected group was higher than that of control group, and that of non-infected group was higher than that of control group. There was significant difference in serum PCT value of T2T3T4 infection group than that of uninfected group. There was no significant difference in serum PCT value of T5 group. 2.The blood WBC value of T4 infection group was higher than that of non-infected group, and the temperature at temperature was higher than that of uninfected group, and the difference was significant. Using serum PCT 鈮，

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