CAJ | 학술논문

目的探讨脑脊液降钙素原测定在早期诊断脑外伤术后患者颅内感染及指导抗生素使用的价值.方法选取40例颅脑外伤术后脑脊液细菌培养阳性的患者作为研究组,40例颅脑外伤术后脑脊液细菌培养阴性的患者作为对照组,分析两组患者的脑脊液PCT水平及血清PCT水平的分布,并对革兰染色阴性及阳性菌的脑脊液PCT水平及治疗前后脑脊液PCT、血清PCT、脑脊液培养进行比较.结果研究组患者的脑脊液PCT及血清PCT均明显高于对照组患者,P＜0.05；研究组患者于抗生素治疗1周后,体温正常后复查,脑脊液PCT明显高于血清PCT和脑脊液培养阳性结果,P＜ 0.05.结论脑脊液PCT检测则更为快捷、准确、方便,对颅脑外伤术后颅内感染的早期诊断更具临床意义；脑脊液PCT检测价值高于血清PCT检测和脑脊液细菌培养,可作为协助判断脑外伤术后患者颅内感染的指标,更能指导抗生素的使用.
목적 탐토뇌척액강개소원측정재조기진단뇌외상술후환자로내감염급지도항생소사용적개치.방법 선취40례로뇌외상술후뇌척액세균배양양성적환자작위연구조,40례로뇌외상술후뇌척액세균배양음성적환자작위대조조,분석량조환자적뇌척액PCT수평급혈청PCT수평적분포,병대혁란염색음성급양성균적뇌척액PCT수평급치료전후뇌척액PCT、혈청PCT、뇌척액배양진행비교.결과 연구조환자적뇌척액PCT급혈청PCT균명현고우대조조환자,P＜0.05；연구조환자우항생소치료1주후,체온정상후복사,뇌척액PCT명현고우혈청PCT화뇌척액배양양성결과,P＜ 0.05.결론 뇌척액PCT검측칙경위쾌첩、준학、방편,대로뇌외상술후로내감염적조기진단경구림상의의；뇌척액PCT검측개치고우혈청PCT검측화뇌척액세균배양,가작위협조판단뇌외상술후환자로내감염적지표,경능지도항생소적사용.
Objective To investigate the value of detection of cerebrospinal fluid calcitonin in the early diagnosis of postoperative intracranial infection in patients undergoing surgery for traumatic brain injury and the value of guidence of antibiotic uses.Methods 40 patients positive cerebrospinal fluid bacterial culture were recruited as a study group,while 40 negative with bacterial culture were enrolled as a control group.The PCT level in cerebrospinal fluid and distribution of serum PCT level were analyzed in both groups.The PCT levels in cerebrospinal fluid in gramnegative and-positive bacteria,PCT in cerebrospinal fluid before and after treatment,serum PCT,and CSF cultures were compared.Results PCT levels in the cerebrospinal fluid and serum were significantly higher in the study group than in the control group (P＜ 0.05); one week after antibiotic therapy,PCT level in cerebrospinal fluid was significantly higher than serum PCT level and positive cerebrospinal fluid bacterial culture in the patients whose temperature returned to normal in the study group (P＜0.05).Conclusions Detection of cerebrospinal fluid PCT is faster and more accurate and convenient.It is of greater clinical significance in the early diagnosis of intracranial infection secondary to surgery for traumatic brain injury.PCT value in cerebrospinal fluid higher than serum PCT value and cerebrospinal fluid bacterial culture can be used as an indicator for predicting of postoperative intracranial infection in patients with traumatic brain injury and guiding uses of antibiotics.