降钙素原指导ICU老年患者抗感染价值研究-急诊医学专业论文.docxVIP

青岛大学 硕士学位论文 降钙素原指导ICU老年患者抗感染价值研究 姓名：宋琦 申请学位级别：硕士 专业：急诊医学 指导教师：于海初降钙素原指导IClJ老年患者抗感染价值研究摘 降钙素原指导IClJ老年患者抗感染价值研究 摘 要 目的 探讨降钙素原(PCT)的水平指导重症监护病房老年患者临床应用抗生素的 价值。 方法 84名重症监护病房细菌感染的老年患者，随机分为常规治疗组和PCT指导 治疗组。常规治疗组按照传统疗法，医生根据抗生素使用指南治疗；血清PCT水平 指导治疗组，根据PCT水平，以确定是否使用抗生素。血清PCT0．25ug／ml，使 用抗生素，血清PCT0．25 ug／ml，非抗生素治疗。比较两纽治疗方法的临床指标， 疗效，抗生素的使用量，抗生素治疗时间。 结果治疗后，患者的白细胞，中性粒细胞，CRP，两组之间无显著性差异。PCT 指导治疗组炎症指数低于常规治疗组，抗生素使用时间显著低于常规治疗组，差异 有统计学意义；抗生素使用率是47。6％和90．5％，差异有统计学意义，常规组显着 高T-PCT组。 结论在ICU参考的血清PCT浓度老年患者使用抗菌药物可以达到更好的治疗效 果，并减少抗生素的使用，减少抗生素的使用时间。PCT水平可以动态反应病情 变化，病情逐渐好转，PCT值逐渐恢复正常。 硕士研究生宋琦(急诊医学) 指导教师 于海初教授 关键词：降钙素原，老年患者，抗菌治疗 The The research of procalcitonin value in guiding ICU elderly patients’anti-infection Abstract objective To evaluate the value of procalcitonin(PCT)levels guiding the clinical use of antibiotics at lCU elderly patients． Methods 84 aged patients with bacterial infection of ICU patients were randomly assigned to conventional treatment group and PCT guidance treatment group． Beside conventional therapy,conventional therapy group use antibiotics by physician in accordance with the decision to antibiotic treatment guidelines，PCT guidance group decide whether use antibiotics by serum PCT0．25 ug，ml， the antibiotic treatment，PCT0．25 ug／ml，the non-antibiotic treatment．The using time，clinical efficacy，utilization，and inflammatory markers after the two groups are all compared． Results After treatment，the two groups PCT group‘S patients white blood cells， neutrophils， CRP compare with the conventional group no significant difference．The two groups before and after treatment，the inflammatory parameters were significantly lower before treatment．PCT group。S PCT lower than before treatment．Meanwhile，antibiotic using time，the conventional group was longer than PCT group，the difference was significant．Antibiotic usage ratio was 90．5％and 47．6％。the difference was statistically significant．PCT group was significantly lower than conventional group Conclusion To antimicrobia