摘要
目的探讨普外科术后感染的危险因素和血清炎性指标变化情况,为早期临床诊断提供参考依据。方法选取2012年7月-2017年9月373例普外科手术患者,并对术后感染率、主要病原菌分布、具体感染部位分布进行单因素和多元回归分析,同时分析患者血清PCT、CRP和IL-2、IL-4、IL-6、IL-10的水平。结果 36例手术感染患者共分离出病原菌54株,其中革兰阴性菌占59.3%,革兰阳性菌占33.3%,真菌及其他病原体占7.4%;在所有菌种中,铜绿假单胞菌检出率最高,占22.2%;年龄≥55岁、合并有基础疾病、住院时间≥5 d是导致术后医院感染的独立危险因素;感染组血清PCT、CRP、IL-6、IL-10含量明显高于对照组(P<0.05);PCT的灵敏度为75.6%,特异度为82.7%,均明显高于CRP及IL-6;PCT、CRP、IL-6 3项联检时,其灵敏度可达86.7%,特异度为89.8%。结论年龄、住院时间及合并的基础疾病是术后感染的重要相关因素,PCT、CRP、IL-6检测对于术后感染的早期诊断具有重要临床应用价值。
Objective To explore the risk factors for postoperative infections and the change of serum inflammatory indexes, so as to provide references for early diagnosis. Methods A total of 373 surgical patients were recruited from July 2012 to September 2017. Univariate analysis and multivariate Logistic regression analysis were performed for the incidence of postoperative infections, distribution of major pathogen species and specific infection sites. The serum concentrations of PCT, CRP, IL-2, IL-4, IL-6, IL-10 were also analyzed. Results Fifty-four pathogens were isolated from 36 patients with infection, including gram-negative bacteria（59.3%）, gram-positive bacteria（33.3%）, Fungi and others （7.4%）. The incidence of P.aeruginosa was the highest among all the pathogens （22.2%）. The independent risk factors for the postoperative infection included the underlying disease, no less than 55 years old, and hospitalization duration no less than 5 days. The levels of PCT, CRP, IL-6, IL-10 in infection group were significantly higher than those in control group （P〈0.05）. The sensitivity and specificity of PCT was 75.6% and 82.7%, higher than that of CRP and IL-6. The sensitivity and specificity of PCT, CRP, IL-6 joint detection was 86.7% and 89.8%. Conclusion Age, hospitalization duration and underlying disease are highly relevant to postoperative infections. PCT, CRP, IL-6 may play critical roles in the early diagnosis of postoperative infections.
作者
陆建龙
黄小华
LU Jianlong;HUANG Xiaohua(Nanxun Hospital of Traditional Chinese Medicine,Nanxun,Zhejiang 313000,China)
出处
《中国卫生检验杂志》
CAS
2018年第14期1768-1770,1773,共4页
Chinese Journal of Health Laboratory Technology
关键词
术后感染
危险因素
炎性指标
Postoperative infection
Risk factor
Inflammatory indexes
