本文關(guān)鍵詞：PCT清除率與△SOFA在復(fù)雜腹腔感染中的預(yù)測價值　出處：《實用醫(yī)學(xué)雜志》2016年24期 　論文類型：期刊論文

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【摘要】：目的:探討PCT清除率(PCT-c)與△感染相關(guān)性器官功能衰竭評分(SOFA)對復(fù)雜腹腔感染患者預(yù)后的評估價值。方法:回顧性分析2013-2015年入住重癥醫(yī)學(xué)科,診斷為復(fù)雜腹腔感染導(dǎo)致嚴(yán)重膿毒癥及感染性休克患者65例,分為生存組和死亡組,記錄診斷當(dāng)天、48 h及5 d時PCT值并計算PCT-c;記錄診斷當(dāng)天、48 h SOFA評分,并計算48 h△SOFA。評價PCT-c與△SOFA在復(fù)雜腹腔感染中的預(yù)測價值。結(jié)果:死亡組中初始PCT值(PCT_0)較生存組高,但差異無統(tǒng)計學(xué)意義。生存組中PCT-c 48 h、PCT-c 5 d均高于死亡組,差異具有統(tǒng)計學(xué)意義(P0.05),死亡組的初始SOFA評分(SOFA_0)較生存組高,△SOFA 48 h較生存組低,差異具有統(tǒng)計學(xué)意義(P0.000 1)。PCT-c 48 h,PCT-c 5 d及△SOFA 48 h的ROC曲線下面積分別為0.774(95%CI 0.61~0.93)、0.761(95%CI 0.61~0.91)及0.752(95%CI 0.60~0.90),PCT-c 48 h預(yù)測價值最高。結(jié)論:PCT-c 48 h,PCT-c 5 d及△SOFA 48 h對于復(fù)雜腹腔感染導(dǎo)致嚴(yán)重膿毒癥及感染性休克患者預(yù)后具有預(yù)測價值。PCT-c 48 h降低提示臨床醫(yī)生需重新評估治療方案的有效性。
[Abstract]:Objective: to investigate the correlation between PCT clearance rate (PCT-c) and infection associated organ failure score (SOFA). Evaluation value of prognosis in patients with complicated abdominal infection methods: retrospective analysis was conducted in the Department of intensive Medicine from 2013 to 2015. 65 patients with severe sepsis and septic shock caused by complicated abdominal infection were divided into survival group and death group. The PCT values were recorded at 48 h and 5 d after diagnosis and PCT-c were calculated. The 48 h SOFA score was recorded on the day of diagnosis. The predictive value of PCT-c and SOFA in complicated abdominal infection was evaluated. Results: the initial PCT value in the death group was higher than that in the survival group. But the difference was not statistically significant. The PCT-c 48 h PCT-c was significantly higher in the survival group than that in the death group (P 0.05). The initial SOFA score of the death group was higher than that of the survival group, and the SOFA 48 h was lower than that of the survival group. The difference was statistically significant (P 0. 000 1 路PCT-c 48 h). The area under the ROC curve of PCT-c 5 d and SOFA 48 h was 0.77495 CI 0.610.93). 0.76195 CI 0.610.91) and 0.75295 CI 0.600.90). PCT-c 48 h was the best predictive value. Conclusion: PCT-c is 48 h. PCT-c 5 d and SOFA 48 h can predict the prognosis of patients with severe sepsis and septic shock caused by complicated abdominal infection. H-reduction suggests that clinicians need to reassess the effectiveness of the treatment regimen.
【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬仁濟醫(yī)院重癥醫(yī)學(xué)科;
【分類號】：R459.7
【正文快照】： 復(fù)雜腹腔感染(complicated intra-abdominalinfections,c IAI)定義為空腔臟器的內(nèi)容物穿入腹腔導(dǎo)致局限性腹膜炎(包括膿腫)、彌漫性腹膜炎,感染源經(jīng)外科處理后,仍殘留細(xì)菌,需使用抗感染藥物。c IAI在ICU致死性感染源中位列第二,早期識別感染控制不良并及時干預(yù)是影響疾病轉(zhuǎn)歸

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