降钙素原动态监测在重症胰腺炎患者连续性肾脏替代治疗中的指导价值

发布时间：2017-12-28 18:14

本文关键词：降钙素原动态监测在重症胰腺炎患者连续性肾脏替代治疗中的指导价值　出处：《广东医学》2016年14期 　论文类型：期刊论文

【摘要】：目的研究降钙素原(PCT)动态监测在重症胰腺炎(SAP)患者连续性肾脏替代治疗(CRRT)中的指导价值。方法选择SAP患者86例,均采用连续性静脉-静脉血液滤过(CVVH)或连续性静脉-静脉血液透析(CVVHD)模式给予CRRT,以入院顺位分为两组,单数43例患者(观察组)动态监测PCT,并根据监测结果指导用药,双数43例作为对照组,常规综合治疗,所有患者均于4周后评价预后(治愈、明显好转、恶化或死亡)。同时比较两组抗生素应用构成、抗生素累计消耗量(cDDDs)、住院费用、住ICU时间。结果观察组应用一种、二种、三种抗菌药物的构成比分别为11.63%、72.09%和16.28%;对照组分别为4.65%、51.16%和44.19%(x~2=7.163,P0.05)。两组抗菌药物使用类型比较差异无统计学意义(P0.05)。观察组cDDDs少于对照组,抗菌药物使用时间、CRRT时间较对照组短,治疗费用低于对照组(P0.05)。4周后,观察组28 d存活率为76.74%;对照组28 d存活率为79.07%(x~2=0.916,P0.05)。结论 SAP患者CRRT中进行PCT监测,并根据PCT水平指导治疗可避免盲目使用抗生素,在保证疗效的同时可缩短抗生素的使用时间和减少用量。
[Abstract]:Objective to study the guiding value of dynamic monitoring of calcitonin (PCT) in continuous renal replacement therapy (CRRT) in patients with severe acute pancreatitis (SAP). Methods 86 cases of SAP patients, with continuous veno venous hemofiltration (CVVH) or continuous veno venous hemodialysis (CVVHD) model in CRRT, in the first place is divided into two groups, "43 patients (observation group) and dynamic monitoring of PCT, according to the monitoring results to guide medication, even 43 cases as control group, routine comprehensive treatment, all patients after 4 weeks to evaluate the prognosis (cured, markedly improved, deterioration or death). At the same time, the application of two groups of antibiotics, the cumulative consumption of antibiotics (cDDDs), the cost of hospitalization, and the time of ICU were compared. Results the constituent ratios of one, two and three antimicrobial agents in the observation group were 11.63%, 72.09% and 16.28%, respectively, while the control group was 4.65%, 51.16% and 44.19% (x~2=7.163, P0.05). There was no significant difference in the use of the two groups of antibiotics (P0.05). The cDDDs in the observation group was less than the control group. The time of use of antibiotics and the time of CRRT were shorter than those of the control group, and the cost of treatment was lower than that of the control group (P0.05). After 4 weeks, the survival rate of 28 d in the observation group was 76.74%, and the survival rate of 28 d in the control group was 79.07% (x~2=0.916, P0.05). Conclusion PCT monitoring in CRRT of SAP patients and guiding treatment according to PCT level can avoid blind use of antibiotics, while ensuring efficacy and shortening the usage time and dosage of antibiotics.
【作者单位】：浙江省温岭市第一人民医院肾内科;浙江省温岭市第一人民医院ICU;
【分类号】：R576
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