Abstract：Objective To investigate the influence of serum procalcitonin (PCT) levels and changes after treatment on the prognosis and survival of patients with severe secondary peritonitis.Methods The clinical data of 118 patients with severe secondary peritonitis after operation admitted to ICU of the Second Affiliated Hospital of Guangzhou Medical University from January 2016 to January 2018 were analyzed retrospectively.According to 28-day survival or not,they were divided into the survival group (95 cases) and the death group (23 cases).One week after treatment,108 surviving patients were divided into the PCT value decreased greater than or equal to 80% group (68 cases) and the PCT value decreased less than 80% group (40 cases).A total of 200 non-infected patients in the same period were selected as the normal control group.The PCT values of 1,3 and 7 days were observed dynamically,and the relationship between PCT values and severity and survival rate was summarized.Results The median of initial PCT values in the death group,the survival group and the normal control group were 9.10,7.91 and 0.04 ng/L,respectively,there was significant difference among the three groups (P＜0.05).The area under the ROC curve of 7-day PCT value was the largest.The cut-off point was 9.3 ng/L,the sensitivity was 0.933,and the specificity was 0.968.There was a positive correlation between the CT value on 3 and 7 day and the length of stay in ICU (P＜0.05).The change of APACHE Ⅱscore was positively correlated with CT value at 3 and 7 days (P＜0.05).The monthly survival rate of the PCT value decreased greater than or equal to 80% group after one week of treatment was significantly higher than that of the PCT value decreased less than 80% group (P＜0.05).Conclusion Dynamic monitoring of serum PCT can evaluate the prognosis of patients with severe secondary peritonitis after surgery.
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