本文關(guān)鍵詞： 糖尿病足 多藥耐藥感染 腔內(nèi)治療 WBC CRP PCT　出處：《中華醫(yī)院感染學(xué)雜志》2017年17期 　論文類型：期刊論文

【摘要】：目的探討白細(xì)胞(WBC)計(jì)數(shù)、C-反應(yīng)蛋白(CRP)及血清降鈣素原(PCT)在經(jīng)腔內(nèi)治療后糖尿病足多藥耐藥感染患者中的表達(dá)變化,對(duì)判斷病情和預(yù)后評(píng)估的影響分析。方法選取醫(yī)院2012年1月-2015年12月治療的糖尿病足感染(DFI)患者115例,并且感染部位分泌物培養(yǎng)均呈多藥耐藥菌(MDRMs)陽性;根據(jù)不同的治療方式隨機(jī)分為研究組59例和對(duì)照組56例,對(duì)照組患者采用胰島素與抗菌藥物常規(guī)治療;研究組在對(duì)照組治療基礎(chǔ)上采用腔內(nèi)介入治療,以治療后1、3、7d為觀察期,比較兩組患者在治療前和觀察期的WBC計(jì)數(shù)、CRP及PCT指標(biāo)水平變化。結(jié)果研究組WBC在治療1、3、7d后分別為(19.48±2.71)×109/L、(12.15±1.13)×109/L、(8.92±0.46)×109/L比對(duì)照組的(23.15±3.09)×109/L、(16.49±2.37)×109/L、(10.28±0.54)×109/L略低(P均0.05);研究組的CRP在治療1、3、7d的指標(biāo)為(119.48±12.53)mg/L、(82.37±5.85)mg/L、(68.14±4.62)mg/L明顯低于對(duì)照組的(123.82±13.32)mg/L、(116.53±12.04)mg/L、(101.83±6.59)mg/L(P均0.05);治療1、3、7d后研究組患者的PCT為(2.45±0.37)μg/L、(1.78±0.24)μg/L、(0.95±0.16)μg/L比對(duì)照組PCT(3.23±0.54)μg/L、(2.17±0.36)μg/L、(2.04±0.09)μg/L下降明顯(P均0.05)。結(jié)論腔內(nèi)治療糖尿病足多藥耐藥菌感染患者,能夠加速患者創(chuàng)口愈合,減輕患者痛苦,將WBC、CRP及PCT指標(biāo)水平控制在理想水平,尤其是對(duì)于抗菌藥物控制不佳的MDRMs感染患者,具有創(chuàng)傷小、操作簡(jiǎn)單、效果良好,降低感染復(fù)發(fā)的優(yōu)勢(shì),值得臨床推薦應(yīng)用。
[Abstract]:Objective to investigate the expression of C- reactive protein (CRP) and serum procalcitonin (PCT) in patients with diabetic foot multidrug resistance (MDR) infection after intracavitary treatment. Methods 115 patients with diabetic foot infection were selected from January 2012 to December 2015 in our hospital. And the secretion culture of infection site showed MDRMspositive. According to different treatment methods, 59 cases in the study group and 56 cases in the control group were randomly divided into two groups. The patients in the control group were treated with routine insulin and antimicrobial drugs. The study group was treated with intracavitary interventional therapy on the basis of the treatment in the control group. The WBC counts of the two groups were compared before and during the observation period. Results the level of WBC in the study group was 19.48 鹵2.71 脳 10 ~ 9 / L after treatment for 1 ~ 3 ~ 3 ~ 7 days, respectively. Compared with the control group (12.15 鹵1.13) 脳 10 9 / L, 8.92 鹵0.46 脳 10 9 / L and 23.15 鹵3.09 脳 10 9 / L, respectively. 10.28 鹵0.54) 脳 10 ~ 9 / L, P < 0.05 ~ 0. 05%, respectively, of 16.49 鹵2.37) 脳 10 ~ (9) / L and 10.28 鹵0.54 脳 10 ~ (9) 路L ~ (-1) / L; The index of CRP in the study group was 119.48 鹵12.53 mg / L, 82.37 鹵5.85 mg / L for 7 days after treatment. 68.14 鹵4.62 mg / L was significantly lower than that of control group (123.82 鹵13.32 mg / L, 116.53 鹵12.04 mg / L). 101.83 鹵6.59 mg / L P 0.05g / L; The PCT of the patients in the study group was 2.45 鹵0.37 渭 g / L, 1.78 鹵0.24 渭 g / L after treatment for 1 day and 3 days later. Compared with PCT(3.23 鹵0.54 渭 g / L, PCT(3.23 鹵0.54 渭 g / L was 2.17 鹵0.36 渭 g / L, respectively. Conclusion endovascular treatment of diabetic foot with multidrug resistant bacteria infection can accelerate wound healing and alleviate the pain of diabetic foot. The levels of WBC C C C P and PCT were controlled at the ideal level, especially for the patients with MDRMs infection with poor control of antimicrobial agents, which had the advantages of less trauma, simple operation and good effect. The advantage of reducing the recurrence of infection is worthy of clinical recommendation.
【作者單位】： 沈陽醫(yī)學(xué)院附屬第二醫(yī)院血管外科;
【分類號(hào)】：R587.2
【正文快照】： 糖尿病足是糖尿病并發(fā)癥中常見的一種[1],是由于患者發(fā)生神經(jīng)性病變使下肢保護(hù)功能逐漸減弱,而下肢組織中的大血管和微血管發(fā)生病變導(dǎo)致動(dòng)脈的灌注不足,血液微循環(huán)產(chǎn)生障礙而引發(fā)的足部潰瘍和壞疽的現(xiàn)象。研究顯示,在糖尿病患者中的糖尿病足發(fā)病率約為20%,我國(guó)每年有10%左右的

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