The Significane Of Procalcitonon Testing In The Perioperative Period Of Valve Replacement For Rheumatic Heart Disease

Objective: To investigate the variation of PCT level and the significance of procalcitonin testing in guiding antibiotic use in the perioperative period of valve replacement for rheumatic heart disease.Methods: Measure the rectal temperature,blood routine(WBC,N%)and procalcitonin(PCT)of 56 patients with rheumatic heart valve disease need valve replacement before and 1,2,3,5,7 days after operation. Use of prophylactic antibiotics in perioperative period guided by serum procalcitonin.Observe and record the duration of prophylactic antibiotics after surgery and postoperative infection complications.Results:The duration of all patients'prophylactic use of antibiotics were 4.6±2.0 days.6 patients suffered from operative incision infections and one suffered from pulmonary infection.There were no severe postoperative infection complications.The body temperature of the patients with no postoperative infection complications rised to the peak(37.6±0.34℃) on the 1st day after operation and return to normal on the 3rd days.It's similar with the patients suffered from operative incision infections.There were no significant difference of the level between the two groups.The temperature of the patient suffered from pulmonary infection rised again after infection on the 5th days and returned to normal on the 7th days.The WBC and N% of the patients with no postoperative infection complications both rised to the peak on the first two days after operation and were not able to return to normal on the 7th days. It's similar with the patients suffered from operative incision infections.There were no significant difference of the level between the two groups. The WBC and N% of the patient suffered from pulmonary infection rised again after infection on the 5th days ,the WBC returned to normal on the 9th days and the N% maintained at a high level.The PCT of the patients with no postoperative infection complications rised to the peak on the 1st day after operation and return to normal on the 3rd days.It's similar with the patients suffered from operative incision infections.There were no significant difference of the level between the two groups.The duration PCT descending to 0.25ng/ml were 3.7±2.5 days. The PCT of the patient suffered from pulmonary infection rised again after infection on the 5th days and returned to normal on the 9th days.Conclusions:Use of prophylactic antibiotics guiding by body temperature and blood routine in perioperative period of valve replacement for rheumatic heart disease are inappropriate.Use of prophylactic antibiotics guiding by PCT in perioperative period of valve replacement can significantly reduce the irrelevantly use of antibiotics than guiding by blood routine.The level of serum PCT increased significantly on the early stage of the valve replacement surgery and return to normal on the 3rd days.