文章摘要
薛 勇,吴化奎,徐广民,孙 伟,梁月坤.ICU行气管切开患者下呼吸道感染危险因素及血清PCT、hCRP联合检测的早期预测价值研究[J].,2020,(12):2380-2384
ICU行气管切开患者下呼吸道感染危险因素及血清PCT、hCRP联合检测的早期预测价值研究
Risk Factors of Lower Respiratory Tract Infection in Patients with Tracheotomy in ICU and Early Predictive Value of Combined Detection of Serum PCT and hCRP
投稿时间:2020-02-18  修订日期:2020-03-15
DOI:10.13241/j.cnki.pmb.2020.12.040
中文关键词: 重症监护室病房  气管切开  下呼吸道感染  超敏C-蛋白  降钙素原  危险因素
英文关键词: Intensive care unit  Tracheotomy  Lower respiratory tract infection  Hypersensitive c-protein  Procalcitonin  Risk factors for
基金项目:安徽省科技基金项目(1010402135)
作者单位E-mail
薛 勇 安徽理工大学第一附属医院(淮南市第一人民医院) 重症医学科 安徽 淮南 232000 weixuezhen2016@163.com 
吴化奎 安徽理工大学第一附属医院(淮南市第一人民医院) 重症医学科 安徽 淮南 232000  
徐广民 安徽理工大学第一附属医院(淮南市第一人民医院) 重症医学科 安徽 淮南 232000  
孙 伟 安徽理工大学第一附属医院(淮南市第一人民医院) 重症医学科 安徽 淮南 232000  
梁月坤 安徽理工大学第一附属医院(淮南市第一人民医院) 重症医学科 安徽 淮南 232000  
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中文摘要:
      摘要 目的:研究ICU行气管切开患者下呼吸道感染危险因素及血清PCT、hCRP联合检测的早期预测价值。方法:选择2017年1月至2019年12月在我院ICU病房接受气管切开患者82例作为研究对象,按照是否下呼吸道感染分为观察组(n=41)和对照组(n=41),观察组为合并下呼吸道感染病人,对照组为无下呼吸道感染病人。对比两组病人的临床资料、特征、血清超敏C-蛋白(hCRP)和降钙素原(PCT)检测值、细菌性感染情况、应用Logistic回归分析其危险因素。结果:年龄、入住ICU时间、气道开放时间、手术时机、呼吸机的应用、侵入性操作、使用抗生素种类及使用抗生素时间等情况与ICU下呼吸道感染病人有关,对比差异显著(P<0.05);观察组病人的PCT及hCRP水平明显高于对照组(P<0.05);通过CURB病情高低分为:高危组8例、中危组11例和低危组22例,高危组病人的血清hCRP和PCT检测值明显高于低危组和中危组(P<0.05);PCT检测的病人灵敏度、特异度、阳性预测值和阴性预测值均高于hCRP的检测结果(P<0.05);年龄、入住ICU时间、手术时间、呼吸机的应用、侵入性操作、气道开放时间及抗生素≥2种≥2周均为ICU行气管切开下呼吸道感染病人的独立危险因素。结论:ICU行气管切开术患者合并下呼吸道感染的危险因素较多,如年龄、入住ICU时间、气道开放时间、手术时机、呼吸机的应用、侵入性操作、使用抗生素种类及使用抗生素时间等均为主要因素,血清PCT及hCRP水平变化可作为ICU下呼吸道感染病人早期诊断和病情检测的指标之一。
英文摘要:
      ABSTRACT Objective: To study the risk factors of lower respiratory tract infection and the early predictive value of serum PCT and hCRP in ICU patients undergoing tracheotom. Methods: From January 2017 to December 2019, 82 patients receiving tracheotomy in the ICU ward of our hospital were selected as the study objects. According to whether or not lower respiratory tract infection was detected, they were divided into the observation group (n=41) and the control group (n=41). The observation group was patients with lower respiratory tract infection, while the control group was patients without lower respiratory tract infection. The clinical data, characteristics, serum hypersensitive c-protein (hCRP) and procalcitonin (PCT) detection values, bacterial infection status and risk factors of the two groups were compared using Logistic regression analysis. Results: Age, ICU admission time, airway opening time, surgical timing, ventilator application, invasive operation, antibiotic types and duration of antibiotic use were significantly correlated with patients with subicu respiratory tract infection (P<0.05). PCT and hCRP levels in the observation group were significantly higher than those in the control group (P<0.05). The patients in the high-risk group were divided into 8 patients in the high-risk group, 11 patients in the medium-risk group and 22 patients in the low-risk group. The serum hCRP and PCT values in the high-risk group were significantly higher than those in the low-risk group and the medium-risk group (P<0.05). The sensitivity, specificity, positive predictive value and negative predictive value of PCT were higher than that of hCRP (P<0.05). Age, ICU admission time, surgical duration, ventilator use, invasive procedures, airway opening time and ≥2 antibiotics ≥2 weeks were independent risk factors for lower respiratory tract infection in patients undergoing tracheotomy in ICU. Conclusion: Line ICU patients with tracheotomy with lower respiratory infection risk factors, such as age, ICU admission time, airway open time, operation time, the application of the breathing machine, invasive operation, types of antibiotics, and use of antibiotics are the main factors such as time, serum PCT and hCRP level changes can be used as a lower respiratory tract infections in the ICU patients early diagnosis and a test of one of the indicators.
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