摘要
目的探讨多指标联合检测对心脏外科术后深部胸骨切口感染的早期预判价值。方法在2019年2月至2022年2月行心脏外科术的患者中选取术后明确发生深部胸骨切口感染的患者83例为观察组,从同期行心脏外科术的患者中选取术后未感染者81例为对照组。记录并对比术前、术后1 d、3 d、7 d对照组和观察组γ-干扰素(IFN-γ)、红细胞沉降率(ESR)、肿瘤坏死因子-α(TNF-α)水平,分析不同检测方式的诊断价值。结果两组术后1 d IFN-γ水平无差异(P>0.05),观察组术后3 d、7 d的IFN-γ水平均高于对照组(P<0.05)。两组术后各时间段ESR水平均高于术前,且观察组术后7 d的ESR水平明显高于对照组(P<0.05)。术后两组TNF-α水平均升高,观察组术后3 d、7 d的TNF-α水平均高于对照组(P<0.05)。IFN-γ+ESR+TNF-α联合诊断心脏外科术后深部胸骨切口感染的敏感度、特异度分别为92.53%、86.26%。结论IFN-γ、ESR及TNF-α均可作为诊断心脏外科术后深部胸骨切口感染的辅助指标,但三者联合检测诊断效能更高,为临床诊治提供基础。
Objective To explore the early predictive value of multi-indicator combined detection for deep sternotomy infection after cardiac surgery.Methods Among the patients who underwent cardiac surgery in our hospital from February 2019 to February 2022,83 patients with deep infection after sternotomy were selected as the observation group,and 81 patients without postoperative infection were selected as the control group.Theγ-interferon(IFN-γ),erythrocyte sedimentation rate(ESR),tumor necrosis factor-α(TNF-α)levels were recorded before operation,1 d,3 d,and 7 d after operation.The diagnostic value of different detection methods was analyzed.Results There was no difference in the levels of IFN-γon day 1 after operation between the two groups(P>0.05).The levels of IFN-γin the observation group on day 3 and day 7 after operation were higher than those in the control group(P<0.05).After operation,the ESR levels of the two groups at any times were higher than those before the operation,and the ESR level of the observation group was significantly higher than that of the control group at 7d after operation(P<0.05).The levels of TNF-αin the two groups increased after operation,and the levels of TNF-αin the observation group were higher than those in the control group at 3d and 7d after operation(P<0.05).The sensitivity and specificity of combined IFN-γ+ESR+TNF-αin the diagnosis of deep sternotomy infection after cardiac surgery were 92.53%and 86.26%,respectively.Conclusions IFN-γ,ESR and TNF-αcan all be used as auxiliary indicators for the diagnosis of deep sternotomy infection after cardiac surgery,but the combined detection of the three has higher diagnostic efficiency,and provides a basis for clinical diagnosis and treatment.
作者
王瑶
刘爽爽
刘志永
王贺
王福朝
WANG Yao;LIU Shuangshuang;LIU Zhiyong;WANG He;WANG Fuchao(Department of Anesthesiology,Hengshui People's Hospital,Hengshui 053000,Hebei,China;Department of Anesthesiology,Afiliated Hospital of Chengde Medical College,Chengde 067000,Hebei,China)
出处
《中国分子心脏病学杂志》
CAS
2022年第4期4805-4808,共4页
Molecular Cardiology of China
基金
河北省2021年度医学科学研究课题(20191176)。
关键词
心脏外科术
深部胸骨切口感染
预判价值
Cardiac surgery
Deep infection of sternotomy
Predictive value
