摘要
目的探讨高通量测序技术在脓毒症患者病原体检测和治疗中的应用价值。方法选取2016年7月~2019年3月我院重症监护病房(ICU)收治的92例脓毒症患者作为研究对象,按照随机数字表法将其分为观察组(47例)和对照组(45例)。对照组给予常规血液培养进行病原体检测,观察组在常规血液培养的基础上联合高通量测序进行病原体检测。比较两组的病原体检测情况(病原体阳性率、病原体报告时间及病原体检出类型)、治疗情况及ICU治疗期间并发症的发生情况。结果64例患者病原体检测阳性,其中观察组45例,阳性率为95.7%;对照组19例,阳性率为42.2%。观察组的病原体阳性率高于对照组,差异有统计学意义(P<0.05)。观察组的病原体报告时间为(2.2±0.3)d,对照组的病原体报告时间为(2.6±0.4)d;两组的病原体报告时间比较,差异无统计学意义(P>0.05)。经ICU治疗后,73例患者存活,其中观察组43例存活,存活率为91.5%,对照组30例存活,存活率为66.7%;观察组的存活率高于对照组,差异有统计学意义(P<0.05)。观察组的ICU治疗时间为(10.5±2.1)d,对照组的ICU治疗时间为(18.1±1.2)d。观察组的ICU治疗时间短于对照组,差异有统计学意义(P<0.05)。在ICU治疗期间,两组的急性肾损伤、低血压和急性肺损伤发生率比较,差异无统计学意义(P>0.05)。结论在脓毒症病原体检测和治疗过程中应用高通量测序技术效果良好,可显著提高脓毒症病原体检测阳性率,缩短脓毒症患者在ICU的治疗时间,同时可明显改善脓毒症患者的治疗预后,值得临床推广。
Objective To investigate the application value of high-throughput sequencing(HTS)in the pathogenic detection and treatment of patients with sepsis.Methods A total of 92 patients with sepsis treated in intensive care unit(ICU)of our hospital from July 2016 to March 2019 were selected as the research object.According to the of random number table method,the patients were divided into the observation group(47 cases)and the control group(45 cases).The control group was treated with conventional blood culture(BC)for the pathogenic detection,and the observation group was treated with conventional BC combined with HTS.The pathogen detection(pathogen positive rate,pathogen reporting time and pathogen detection type),treatment status and complications during ICU treatment were compared between the two groups.Results The pathogens were positive in 64 patients,including 45 cases in the observation group,95.7%in the control group and 19 cases in the control group,with a positive rate of 42.2%.The positive rate of pathogen in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).The pathogen reporting time of the observation group was(2.2±0.3)d,and the pathogen reporting time of the control group was(2.6±0.4)d.There was no significant difference in the reported time of pathogens between the two groups(P>0.05).After ICU treatment,73 patients survived,of which 43 patients survived in the observation group,the survival rate was 91.5%,and 30 patients in the control group survived with a survival rate of 66.7%.The survival rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).The ICU treatment time of the observation group was(10.5±2.1)d,and the ICU treatment time of the control group was(18.1±1.2)d.The ICU treatment time of the observation group was shorter than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the inci
作者
曹燕
刘易林
李莉
李晓勇
孙烨
钟利民
谢恒
刘科成
CAO Yan;LIU Yi-lin;LI Li LI;Xiao-yong;SUN Ye;ZHONG Li-min;XIE Heng;LIU Ke-cheng(Department of Critical Care Medicine,Yuebei People′s Hospital,Yuebei People′s Hospital Affiliated to Shantou University Medical College,Guangdong Province,Shaoguan 512026,China)
出处
《中国当代医药》
2019年第33期8-11,共4页
China Modern Medicine
基金
广东省韶关市卫生计生科研项目(Y18064)
广东省韶关市科技计划项目(2018sn109)
关键词
高通量测序
血液培养
脓毒症
病原学
High-throughput sequencing
Sepsis
Pathogenic detection
Treatment
