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目的探讨血清降钙素原(PCT)检测在新生儿呼吸机相关性肺炎(VAP)治疗中对抗菌药物使用的指导意义。方法选取56例新生儿呼吸机相关性肺炎患儿随机分成两组:PCT组30例,对照组26例,PCT组根据血清PCT检测水平来判断抗生素的使用;常规组根据患者血CRP、X线胸片、痰培养以及其他实验室检查判断抗生素的使用。观察两组新生儿的抗生素使用时间、使用率、住院时间、死亡率等。结果 PCT组的抗生素使用时间为(9.5±1.9)d,对照组为(11.8±2.1)d,两组差异有统计学意义(t=4.3,P=0.0001);两组的抗生素使用率、住院时间、死亡率及再发率差异无统计学意义(P>0.05)。结论 PCT可有效指导新生儿呼吸机相关性肺炎的抗生素治疗,明显缩短抗生素使用时间,减少抗生素暴露。
Objective To investigate the significance of serum procalcitonin (PCT) test in the use of antimicrobial agents in the treatment of neonatal ventilator-associated pneumonia (VAP). Methods Fifty-six neonates with ventilator-associated pneumonia were randomly divided into two groups: 30 cases in PCT group and 26 cases in control group. The PCT group was used to determine the use of antibiotics according to serum PCT level. According to CRP, X-ray Chest radiography, sputum culture and other laboratory tests to determine the use of antibiotics. Two groups of neonatal antibiotic use time, utilization, hospital stay, mortality and so on. Results The antibiotic use time was (9.5 ± 1.9) days in the PCT group and (11.8 ± 2.1) days in the control group, with significant difference between the two groups (t = 4.3, P = 0.0001) There was no significant difference in time, mortality and recurrence rate (P> 0.05). Conclusion PCT can effectively guide the antibiotic treatment of neonatal ventilator-associated pneumonia, significantly shorten the antibiotic use time and reduce the antibiotic exposure.