Ali ARSLAN, Semih Kıvanç OLGUNER, Vedat AÇIK, Faruk İLDAN, Ali İhsan ÖKTEN

Ventrikülostomi sonrası gelişen enfeksiyon tanısında prokalsitoninin C-reaktif protein, beyaz küre ve ateşle karşılaştırılması

Amaç: Bu çalışmada beyin cerrahisinin prokalsitonin düzeylerine etkisini ve prokalsitoninin beyin cerrahisinin yaratmış olduğu enflamatuar reaksiyonla, postoperatif gelişen enfeksiyonu ayırt etme özelliği araştırılmıştır.Gereç ve Yöntem: Çalışmamız 10’unda ventriküler drenaj, 17’sinde ventriküloperitoneal şant uygulanan 27 hidrosefalili hastada yapılmıştır. Preoperatif 1 ve postoperatif 7 gün boyunca Prokalsitonin, Beyaz küre sayısı, C-reaktif protein ve ateş değerlerindeki değişimler incelenmiştir.Bulgular: Tüm hastalarda postoperatif 1. günde preoperatif değerlere göre ateş değerlerinde anlamlı yükseklik tespit edilmiştir. C-reaktif proteinin postoperatif 2. günde pik yaptığı ve daha sonra azalma paterni gösteren düzenli bir kinetik izlediği gözlenmiştir. Postoperatif 5. günde, C-reaktif proteinin halen preoperatif değerinin 3 katı kadar yüksek olduğu tespit edilmiştir. Prokalsitoninin enfeksiyon gelişmeyen tüm hastalarda postoperatif normal sınırları aşmadığı, enfeksiyon gelişen hastalarda ise arttığı gözlenmiştir.Sonuç: Gelecekte daha fazla hasta sayısı ve farklı operasyon türlerini de içeren gruplarla yapılacak çalışmaların sonuçlarıyla prokalsitoninin beyin cerrahi sonrası sistemik komplikasyonları takipte ciddi ve güvenli bir parametre olacağını düşünmekteyiz.

Anahtar Kelimeler:

Prokalsitonin, Ventrikülostomi İlişkili Enfeksiyon

Comparison of procalcitonin, C-reactive protein, white blood cell and body temperature in the diagnosis of ventriculostomy-associated infection

Purpose: The aim of this study was to evaluate the effect of neurosurgical procedures on procalcitonin levels and the role of procalcitonin in distinguishing the inflammatory reaction due to surgery and postoperative infection.Materials and Methods: This study was performed on 27 patients with hydrocephalus. Among these patients, 10 patients had ventricular drainage while 17 had ventriculoperitoneal shunt. The changes in the values of procalcitonin, white blood cell count, C-reactive protein and body temperature were examined in the preoperative 1st and during postoperative 7 days. Results: All the patients had statistically significant increase in the body temperature values of the postoperative 1st day compared to preoperative values. C-reactive protein peaked in the postoperative 2nd day and, after that, followed a regular kinetic to show a decrease pattern. C-reactive protein was found to be 3 times higher in the postoperative 5th day compared to the preoperative value. Procalcitonin was found to remain in normal limits in all the patients that did not develop infection while the same was observed to increase in patients with infection.Conclusion: Procalcitonin will be a serious and safer parameter for the follow-up of the systemic complications following surgery upon the conclusions obtained with studies that include a higher number of patients and varying types of operations.

Keywords:

Procalcitonin, Ventriculostomy-Associated Infection,

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