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目的研究重症监护室(ICU)患者降钙素原(PCT)测定与患者抗菌药物使用强度(AUD)及用药频度(DDDs)的关联性。方法 60例ICU救治的外伤患者,随机分为实验组与对照组,每组30例。对照组按照ICU救治程序常规抗感染治疗,实验组行血浆PCT测定并依据检测结果决定患者抗生素使用。对比两组AUD、DDDs及ICU住院天数。结果实验组的PCT测定结果为(3.8±1.5)ng/ml,根据PCT测定值<0.5 ng/ml时不使用抗生素;PCT介于0.5~1.0 ng/ml时建议使用抗生素但不得联合使用抗生素;当PCT结果 >1.0 ng/ml建议适当提升抗生素使用强度或联合使用两种抗生素的抗生素使用的管理规定,实验组AUD、DDDs及患者ICU住院天数[(37.9±5.8)、(3830±1030)、(8.0±1.5)d]与对照组[(80.5±9.1)、(7850±1680)、(15.0±2.5)d]比较,差异均有统计学意义(P<0.05)。结论 ICU外伤患者普遍存在细菌感染,参照PCT检测结果调整抗生素使用,能有效降低抗生素使用并缩短患者平均住院时间。
Objective To study the association of procalcitonin (PCT) in patients with intensive care unit (ICU) with the strength of use of antimicrobial agents (AUD) and frequency of dosing (DDDs). Methods 60 cases of ICU trauma patients were randomly divided into experimental group and control group, 30 cases in each group. Control group in accordance with routine ICU treatment routine anti-infective treatment, experimental group plasma PCT determination and based on test results to determine the use of antibiotics in patients. Compare two sets of AUD, DDDs and ICU hospitalization days. Results The results of the PCT test in the experimental group were (3.8 ± 1.5) ng / ml, no antibiotics were used when the PCT value was <0.5 ng / ml, antibiotics were recommended at PCTs between 0.5 and 1.0 ng / ml, When the PCT result> 1.0 ng / ml, it is recommended to appropriately improve the use of antibiotics or the antibiotics used in combination. The AUD and DDDs in the experimental group and the length of hospital stay in ICU [(37.9 ± 5.8), (3830 ± 1030), (8.0 ± 1.5) d] compared with the control group [(80.5 ± 9.1), (7850 ± 1680) and (15.0 ± 2.5) d], respectively. Conclusions Bacterial infections are common in patients with ICU trauma and the use of antibiotics is adjusted according to PCT test results, which can effectively reduce the use of antibiotics and shorten the average length of hospital stay.