摘要
目的分析髋关节置换术后中性粒细胞与淋巴细胞比率(NLR)和D-二聚体(D-D)表达水平及其对术后感染的预测价值。方法纳入2018年8月-2021年1月襄阳市中心医院行髋关节置换术患者150例,分析其术后感染率和病原菌分布,采用受试者工作特征(ROC)曲线分析NLR、D-D对术后感染的预测价值,多因素分析髋关节置换术后感染的影响因素。结果16例患者在术后发生感染(10.67%),均为慢性假体周围感染,检出病原菌20株,其中革兰阳性菌、革兰阴性菌分别为12株、8株;感染组术后1 d、3 d、7 d NLR、D-D、血沉、降钙素原(PCT)、C-反应蛋白(CRP)、白细胞计数(WBC)均高于非感染组(P<0.05);术后3 d NLR、D-D预测髋关节置换术后感染的敏感度分别为77.41%、75.18%,特异度分别76.25%、74.59%,曲线下面积分别为0.819、0.810;多因素分析结果,年龄、糖尿病病史、NLR、D-D、手术时间、长期类固醇激素使用史均是髋关节置换术后感染的影响因素(P<0.05)。结论髋关节置换术后患者可受多因素影响发生感染,而NLR、D-D在髋关节置换术后感染中有一定预测价值,可予以监测。
OBJECTIVE To explore the postoperative neutrophil-to-lymphocyte ratio(NLR)and D-dimer(D-D)expression level in patients undergoing hip replacement and analyze the value in prediction of postoperative infection.METHODS A total of 150 patients who underwent hip replacement in Xiangyang Central Hospital from Aug 2018 to Jan 2021 were enrolled in the study.The incidence of postoperative infection and distribution of pathogens were analyzed.The values of NLR and D-D in prediction of postoperative infection were analyzed by using receiver operating characteristic(ROC)curves.Multivariate analysis was performed for the influencing factors for postoperative infection in the patients undergoing hip replacement.RESULTS Totally 16(10.67%)patients had postoperative infection,all of whom were chronic peri-prosthetic joint infection.A total of 20 strains of pathogens were isolated,12 of which were gram-positive bacteria,and 8 were gram-negative bacteria.The NLR,D-D,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and white blood cell(WBC)of the infection group were higher than those of the non-infection group after the surgery for 1,3 and 7 days(P<0.05).The sensitivities of NLR and D-D 3 days after the surgery were respectively 77.41%and 75.18%in prediction of postoperative infection in the patients undergoing hip replacement,the specificities were 76.25%and 74.59%,respectively;the areas under curves were respectively 0.819 and 0.810.The result of multivariate analysis showed that the age,history of diabetes mellitus,NLR,D-D,operation duration and long-term use of steroid hormones were the influencing factors for the postoperative infection in the patients undergoing hip replacement(P<0.05).CONCLUSION There are a variety of influencing factors for the postoperative infection in the patients undergoing hip replacement.The NLR and D-D have certain value in prediction of postoperative infection.
作者
郭永春
曹耀威
王喆
魏驰
汪冰
GUO Yong-chun;CAO Yao-wei;WANG Zhe;WEI Chi;WANG Bing(Xiangyang Central Hospital,Xiangyang,Hubei 441021,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2023年第10期1530-1534,共5页
Chinese Journal of Nosocomiology
基金
湖北省科研基金项目(2020HJ021411)。
