摘要
目的探究血清炎性指标在骨科术后感染早期诊断中的应用价值。方法选取2016年6月至2019年6月山东省立第三医院骨科手术治疗的3 314例四肢骨折患者作为研究对象,根据术后有无感染分为58例感染组和3 256例对照组,两组患者术前、后1、3、7d外周血白细胞计数(WBC)、中性粒细胞计数(NEU)、C-反应蛋白(CRP)及红细胞沉降率(ESR)、血清降钙素原(PCT)炎性指标进行检测并观察患者手术前后各炎性指标的变化,分析各炎性指标与术后感染的相关性,采用受试者工作特征曲线(ROC曲线)评价各指标术后感染诊断中的价值。结果术后3d、7d感染组WBC、NEU、CRP、ESR和PCT水平均显著高于对照组,差异有统计学意义(P<0.05)。术后3dCRP、ESR、PCT水平对诊断术后感染均具有较高的临床价值,但三者联合检测诊断术后感染的灵敏度和特异度更高。结论四肢骨骨折患者术后伴随炎性指标水平的变化,CRP、ESR和PCT水平与术后感染的发生关系密切,三者联合检测在四肢骨骨折术后感染早期诊断中具有较高的临床应用价值。
Objective To explore the value of serum inflammatory indexes in the early diagnosis of postoperative infection in orthopedics.Methods A total of 3 314 patients with limb fractures treated by orthopaedic surgery in Shandong Third Hospital from June 2016 to June 2019 were selected as the research objects,and were divided into an infection group of 58 cases and a control group of 3 256 cases according to postoperative infection.Peripheral blood white blood cell count(WBC),neutrophil count(NEU),C-reactive protein(CRP)and red blood cell sedimentation rate(ESR),serum procalcitonin(PCT)and other inflammatory indicators are monitored.Observe the changes of various inflammatory indexes before and after surgery,analyze the correlation between each index and early infection,and use the the receiver operating characteristic curve(ROC curve)to evaluate the value of each index in early infection diagnosis.Results WBC,NEU,CRP,ESR and PCT levels were significantly higher in the infection group 3 days and 7 days after operation than in the control group,the differences were statistically significant(P<0.05).The levels of CRP,ESR,and PCT at 3 days after surgery had high clinical value for the diagnosis of postoperative infections,but the combined detection of the three methods had higher sensitivity and specificity for the diagnosis of postoperative infections.Conclusion CRP,ESR and PCT are closely related to the occurrence of postoperative infection in patients with limb fracture,and combined detection of the three is of high clinical application value in the early diagnosis of postoperative infection in patients with limb fracture.
作者
刘其飞
钱玉英
张在清
LIU Qifei;QIAN Yuying;ZHANG Zaiqing(Department of Emergency Surgery,Shandong Provincial Third Hospital,Cheeloo College of Medicine,Shandong University,Ji′nan,Shandong 250031,China;Department of Nephrology,Affiliated Hospital of Shandong Academy of Medical Sciences,Ji′nan,Shandong 250031,China;Department of Orthopaedics,Linyi Central Hospital,Linyi,Shandong 276000,China)
出处
《检验医学与临床》
CAS
2020年第16期2295-2298,2302,共5页
Laboratory Medicine and Clinic
关键词
骨折
术后感染
炎性指标
fracture
postoperative infection
inflammatory indexes
