The application of serum procalcition in early diagnosis of nosocomial infection in severe cerebral injury / 中国基层医药

Objective To investigate clinical value of serum procalcition(PCT) in early diagnosis of nosocomial infection in severe cerebral injury.Methods 58 patients with severe cerebral injury needing ICU monitoring were enrolled.Levels of serum PCT and C-reactive protein(CRP) and white blood cell(WBC) and nosocomial infection when entering ICU or on days 3 were observed.Results There were not difference in level Serum PCT when entering ICU in infection group compared with non-infection group(P ＞ 0.05).Serum PCT increeassd remarkably when entering ICU on days 3 in infection group as compared with non-infection group,the difference was significant (t =5.44,P ＜ 0.01).There were not difference in CRP and WBC level when entering ICU or on days 3 (all P ＞ 0.05).Conclusion Detection of serum PCT helps diagnosis early nosocomial infection in patients with severe cerebral injury.It is suggested that antibiotics should be chosen early in patients with obviously increased PCT,control abuse of antibiotics contributes to reduce incidence of drug resistance and mortality.

Application of percutaneous dilational tracheostomy in the critical patients / 中国基层医药

Objective To study the clinical value of percutaneous dilational tracheostomy(PDT) in the critical patients. Methods 56 critical patients who needed mechanical ventilation hospitalized in ICU were enrolled and divided into two groups: PDT group ,25 cases and 0T groups ,31 cases. The length of incision wound, duration of operation, amount of haemorrhage, complications were observed. Results The operation time was significantly shortened [(9.9±3.4)minutes vs (27.2 ±5.1)minutes],blood loss was significantly decreased[(5.2±2.2)ml vs (18.2±3. 5)ml] ,size of operation incision was significantly shorter[(15.0 ± 1. 6)mm vs (41.2 ±3.9)mm],lacking oxygen time was significantly shorter [(10.2±2.1) seconds vs (31.1 ±6.2) seconds] in PDT group compared with OT group (all P＜0. 01). PDT had less subcutaneous emphysema and incision bleeding in PDT group than those in OT group (all P＜0.05). Conclusion PDT was easier in performance with less complication,and was deserved to apply in critical patients.