【摘要】 目的:探讨分析降钙素原(PCT)监测在肝脓肿继发脓毒血症停药指导中的价值。方法:选取2018年1月至2022年12月收治的120例肝脓肿继发脓毒血症患者，将60例常规抗菌药物治疗患者作为对照组(RAT组),60例PCT监测指导抗菌药物治疗患者作为PCT组。RAT组患者根据脓毒血症抗菌药物治疗原则选择及停用抗菌药物，PCT组患者再此基础上监测PCT水平变化，PCT下降>90%或PCT<0.25μg/L作为停用抗菌药物指征。比较两组患者一般情况、抗菌药物使用情况及28 d感染复发率、病死率情况。结果:PCT组抗菌药物使用时间(8.27±0.39)d,低于RAT组(10.15±0.63)d(P<0.05)。两组患者停药后体温、白细胞计数、心率、氧合指数、急性生理与慢性健康评分系统(APACHE)Ⅱ评分、住院时间、重症监护病房(ICU)住院时间、28 d感染复发率、28 d病死率组间比较差异无统计学意义(P>0.05)。治疗后第3天起，RAT组和PCT组生存患者血清PCT水平逐渐降低，且生存患者血清PCT水平低于死亡患者(P<0.05)。结论:对肝脓肿继发脓毒血症患者进行PCT监测有助于明确停用抗菌药物情况，进而减少抗菌药物使用，且不影响患者预后，具有较高临床应用价值。更多还原

【Abstract】 Objective:To investigate the value of procalcitonin(PCT) monitoring in the guidance of discontinuation of secondary sepsis in hepatic abscess.Methods:120 patients with secondary sepsis of liver abscess admitted to our hospital from January 2018 to December 2022 were selected, and 60 patients in the conventional antibacterial therapy group were selected as RAT group and 60 patients in the PCT monitoring guided antibacterial therapy group as PCT group. Patients in the RAT group were selected and stopped using antibiotics according to the principle of antibiotic therapy for sepsis, and patients in the PCT group were monitored on this basis, and the PCT level decreased by more than 90% or the PCT was lower than 0.25 μg/L as an indication of stopping antibiotics. The general situation, use of antibiotics, 28 d infection recurrence rate and mortality of the two groups were compared.Results:The duration of antibiotic use in the PCT group was 8.27±0.39 days, which was shorter than that in the RAT group(10.15±0.63 days)(P<0.05). There were no differences in body temperature, white blood cell count, heart rate, oxygenation index, APACHEⅡ score, length of stay, length of ICU stay, 28 days infection recurrence rate and 28 days mortality between the two groups after drug withdrawal(P>0.05). From the 3rd day after treatment, the serum PCT level of surviving patients in RAT group and PCT group was gradually decreased, and the serum PCT level of surviving patients was lower than that of dead patients(P<0.05).Conclusion:The monitoring of procalcitonin in patients with secondary sepsis of liver abscess is helpful to clarify the discontinuation of antibiotics, thus reducing the use of antibiotics without affecting the prognosis of patients, and has high clinical application value.更多还原