摘要
目的探究血清白细胞计数(WBC)、中性粒细胞与淋巴细胞比值(NLR)及C-反应蛋白(CRP)水平,对腹腔镜下结直肠癌根治术后切口感染的预测价值。方法回顾性分析2019年1月—2019年6月于空军军医大学第一附属医院行腹腔镜根治术的结直肠癌患者200例的临床资料,通过分析其临床资料和随访结果,归纳患者术后切口感染的影响因素,并应用受试者工作特征曲线(ROC),评估WBC、NLR和CRP水平对患者术后并发切口感染的预测能力。结果200例患者术后有34例出现切口感染,感染率为17.00%;其中革兰阴性菌32株(78.05%),以大肠埃希菌为主(60.98%);革兰阳性菌9株(21.95%),以金黄色葡萄球菌为主(17.07%);营养不良、糖尿病及NLR水平均是患者术后切口感染的影响因素(P<0.05);WBC、NLR和CRP联合检测对结直肠癌患者术后切口感染发生的预测价值最高(P<0.05),曲线下面积(AUC)为0.951(95%CI:0.912~0.977),敏感度为91.20%,特异度为92.20%。结论结直肠癌患者术后切口感染影响因素众多,主要病原菌为革兰阴性菌,血清WBC、NLR和CRP联合检测对患者术后切口感染发生有较高的预测价值。
OBJECTIVE To explore the predictive value of serum white blood cell count(WBC),neutrophil-to-lymphocyte ratio(NLR)and C-reactive protein(CRP)in the prediction of incision infection after laparoscopic colorectal cancer radical surgery.METHODS The clinical data of 200 patients with colorectal cancer who underwent laparoscopic radical surgery in Xijing Hospital of Air Force Military Medical University during the period from Jan.2019 to Jun.2019 were retrospectively analyzed.By analyzing the clinical data and follow-up results,the influencing factors of postoperative incision infection were summarized,and the predictive efficiency of WBC,NLR and CRP levels in postoperative incision infection was evaluated by receiver operating characteristic(ROC)curves.RESULTS Incision infection occurred in 34 of 200 patients after surgery,with infection rate of 17.00%.There were 32 strains of Gram-negative bacteria(78.05%),mainly Escherichia coli(60.98%),and 9 strains of Gram-positive bacteria(21.95%),mainly Staphylococcus aureus(17.07%).Malnutrition,diabetes and NLR level were the influencing factors of postoperative incision infection(P<0.05).The predictive value of combined detection of serum WBC,NLR and CRP for postoperative incision infection in colorectal cancer patients was the highest(P<0.05).And the area under the curve(AUC),sensitivity and specificity were 0.951(95%CI:0.912-0.977),91.2%and 92.2%,respectively.CONCLUSION There were many factors affecting postoperative incision infection in patients with colorectal cancer.The main pathogens were Gram-negative bacteria.The combined detection of serum WBC,NLR and CRP had a high predictive value for occurrence of postoperative incision infection.
作者
王珂
李世森
闫沛
刘小娟
戴艳然
WANG Ke;LI Shi-sen;YAN Pei;LIU Xiao-juan;DAI Yan-ran(Xijing Hospital of Air Force Military Medical University,Xi'an,Shaanxi 710032,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2020年第19期2995-2999,共5页
Chinese Journal of Nosocomiology
基金
陕西省科研基金资助项目(2016BH489)。
关键词
白细胞计数
中性粒细胞与淋巴细胞比值
C-反应蛋白
结直肠癌
术后切口感染
White blood cell count
Neutrophil-to-lymphocyte ratio
C-reactive protein
Colorectal cancer
Postoperative incision infection
