论文部分内容阅读
目的:评价降钙素原(PCT)指导抗菌治疗策略在小儿肺炎优化抗生素使用中的价值。方法:2012年1月1日至2012年7月31日我院就诊的小儿肺炎患儿272例,随机分为PCT指导治疗组(观察组)142例和常规治疗组(对照组)130例。观察组在入院第1、3、5、7天检测PCT水平,通过检测血清PCT水平来指导抗生素使用,如PCT<0.25μg/L停用或不使用抗生素;对照组由医师按照抗生素使用指南决定是否使用抗生素。比较两组患儿抗生素使用时间、抗生素使用率、住院时间、预后以及观察组患儿经抗生素治疗后PCT水平的变化。结果:观察组抗生素使用时间较对照组明显缩短[(5.42±0.48)d vs(7.82±1.02)d,P<0.05],抗生素使用率较对照组明显降低(63.4%vs 96.2%,P<0.05),住院时间较对照组明显缩短[(6.24±0.35)d vs(8.76±0.76)d,P<0.05),但两组预后比较差异无统计学意义(P>0.05);观察组需使用抗生素患儿经抗生素治疗3 d后PCT水平较入院时降低(χ2=12.52,P<0.05),治疗5 d及7 d后较入院时明显下降(χ2=15.86,18.86,P<0.01)。结论:动态监测PCT水平可指导小儿肺炎抗生素的使用时机,减少不必要的抗生素使用,缩短抗生素使用时间和住院时间。
Objective: To evaluate the value of procalcitonin (PCT) -mediated antibacterial therapy strategy in optimizing the use of antibiotics in pediatric pneumonia. Methods: From January 1, 2012 to July 31, 2012, 272 children with pediatric pneumonia admitted to our hospital were randomly divided into two groups: 142 patients in the PCT-guided treatment group (observation group) and 130 patients in the conventional treatment group (control group). In the observation group, PCT levels were detected on the 1st, 3rd, 5th and 7th days of admission, and antibiotics were instructed by detecting serum PCT level, such as antibiotics with or without PCT <0.25μg / L and control group Whether to use antibiotics. The antibiotic use time, antibiotic use rate, hospital stay, prognosis and changes of PCT level in antibiotic treatment group were compared between the two groups. Results: The antibiotic use time in the observation group was significantly shorter than that in the control group [(5.42 ± 0.48) d vs (7.82 ± 1.02) d, P <0.05], and the antibiotic use rate was significantly lower than that in the control group (63.4% vs 96.2%, P <0.05 ), The hospitalization time was significantly shorter than that of the control group [(6.24 ± 0.35) d vs (8.76 ± 0.76) d, P <0.05), but there was no significant difference in prognosis between the two groups (P> 0.05) After 3 days of treatment with antibiotics, the PCT level was lower than that at admission (χ2 = 12.52, P <0.05). The levels of PCT decreased significantly on admission and on the 5th and 7th day after treatment (χ2 = 15.86,18.86, P <0.01). Conclusions: Dynamic monitoring of PCT levels can guide the timing of pediatric pneumonia antibiotics, reduce unnecessary use of antibiotics and shorten antibiotic use and hospital stay.