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中华危重症医学杂志(电子版) ›› 2016, Vol. 09 ›› Issue (02) : 105 -108. doi: 10.3877/cma.j.issn.1674-6880.2016.02.007

所属专题: 文献

论著

选择性肠道去污对非感染性创伤患者合并血清降钙素原升高的治疗作用
左志刚1, 裴柳2, 宋德刚1, 宋维鹏1, 刘秀娟1, 邱方1,()   
  1. 1. 066000 河北秦皇岛,秦皇岛市第一医院重症医学科
    2. 066000 河北秦皇岛,秦皇岛市第一医院检验科
  • 收稿日期:2015-09-26 出版日期:2016-04-01
  • 通信作者: 邱方
  • 基金资助:
    秦皇岛市科技计划项目(201401A156)

Effect of selective decontamination of digestive tract for non-infective trauma patients with procalcitonin elevation

Zhigang Zuo1, Liu Pei2, Degang Song1, Weipeng Song1, Xiujuan Liu1, Fang Qiu1,()   

  1. 1. Department of ICU, the First Hospital of Qinghuangdao, Qinghuangdao 066000, China
    2. Department of Clinical Laboratory, the First Hospital of Qinghuangdao, Qinghuangdao 066000, China
  • Received:2015-09-26 Published:2016-04-01
  • Corresponding author: Fang Qiu
  • About author:
    Corresponding author: Qiu Fang, Email:
引用本文:

左志刚, 裴柳, 宋德刚, 宋维鹏, 刘秀娟, 邱方. 选择性肠道去污对非感染性创伤患者合并血清降钙素原升高的治疗作用[J/OL]. 中华危重症医学杂志(电子版), 2016, 09(02): 105-108.

Zhigang Zuo, Liu Pei, Degang Song, Weipeng Song, Xiujuan Liu, Fang Qiu. Effect of selective decontamination of digestive tract for non-infective trauma patients with procalcitonin elevation[J/OL]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2016, 09(02): 105-108.

目的

探讨选择性肠道去污治疗对非感染性创伤合并血清降钙素原升高患者的影响。

方法

将80例伴有血清降钙素原升高的非感染性创伤患者分为实验组和对照组,每组40例。其中实验组患者给予选择性肠道去污治疗,对照组给予生理盐水对照处理。连续监测所有患者血清降钙素原及内毒素水平的变化。并于治疗14 d后观察有无急性肾损伤发生。

结果

实验组患者血清降钙素原治疗后第7、9、11、13天分别为(1.29 ± 0.26)、(0.89 ± 0.15)、(0.56 ± 0.16)、(0.50 ± 0.18)μg/L,内毒素水平分别为(82 ± 12)、(53 ± 8)、(47 ± 8)、(34 ± 6)EU/L,对照组患者治疗后第7、9、11、13天分别血清降钙素原为(3.90 ± 0.64)、(3.52 ± 0.45)、(3.98 ± 0.78)、(3.56 ± 0.08)μg/L,内毒素水平分别为(101 ± 18)、(113 ± 17)、(108 ± 13)、(96 ± 16)EU/L,实验组患者血清降钙素原(t=23.906、35.279、27.236、36.406,P均< 0.05)及内毒素均明显低于对照组患者(t=5.705、20.407、24.989、22.901,P均< 0.05)。同时,对照组发生急性肾损伤风险高于实验组(27/40 vs. 15/40,χ2=7.218,P<0.05)。

结论

非感染性创伤合并降钙素原升高的患者为肠源性感染,选择性肠道去污治疗可明显降低血清降钙素原及内毒素水平,从而减小后续治疗中发生急性肾损伤的风险。

Objective

To investigate the effect of selective decontamination of the digestive tract on the non-infective trauma patients with procalcitonin elevation.

Methods

A total of 80 non-infective trauma patients with procalcitonin elevation were randomly divided into the experiment group and control group, 40 cases in each group. The patients in the experiment group were treated with selective intestinal decontamination, and patients in the control group received normal saline at the same time. The levels of serum procalcitonin and endotoxin were monitored continuously. And the acute kidney injury (AKI) were assessed in the two groups.

Results

At 7, 9, 11, 13 d after treatment, the procalcitonin levels and the endotoxin levels were significantly lower in the experiment group than those in the control group (1.29 ± 0.26 vs. 3.90 ± 0.64, 0.89 ± 0.15 vs. 3.52 ± 0.45, 0.56 ± 0.16 vs. 3.98 ± 0.78, 0.50 ± 0.18 vs. 3.56 ± 0.08 μg/L, t=23.906, 35.279, 27.236, 36.406, all P<0.05; and 82±12 vs. 101 ± 18, 53 ± 8 vs. 113 ± 17, 47 ± 8 vs. 108 ± 13, 34 ± 6 vs. 96 ± 16 EU/L, t=5.705, 20.407, 24.989, 22.901, all P<0.05). Meanwhile, the rate of AKI in the control group were higher than those in the experiment group (27/40 vs. 15/40, χ2=7.218, P<0.05).

Conclusion

Our research further confirmed that the reason of non-infective trauma patients with procalcitonin elevation is belong to intestinal infection, and selective decontamination of digestive tract can be significantly reduced the level of procalcitonin and endotoxin, and thereby reduce the risk of AKI in follow-up treatment.

表1 两组"非感染性"创伤伴降钙素原升高患者各时间点降钙素原水平(μg/L,±s
表2 两组"非感染性"创伤伴降钙素原升高患者各时间点内毒素水平(EU/L,±s
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