摘要
目的探讨手术后切口感染患者外周血炎性指标的变化,为手术后切口感染预防控制提供实验室依据。方法选择2006年1月-2011年5月普外科162例手术患者,依据是否发生切口感染分为感染组80例、非感染组82例,基础疾病感染组分别为创伤急诊组27例、胃肠疾病组25例、肝胆疾病组28例,非感染组分别为创伤急诊组27例、胃肠疾病组25例、肝胆疾病组30例;选择正常人80名,为对照组;采用自动电阻式血细胞计数法检测中性粒细胞绝对值计数(ANC),采用流式细胞仪测定法检测多形核粒细胞CD64(PMNCD64),采用ELISA法检测可溶性CD86(sCD86)和亲环素A(CyPA)。结果 ANC水平感染组为(16.73±6.73)×109/L、非感染组为(5.98±2.56)×109/L、正常组为(4.6±1.27)×109/L,差异有统计学意义(P<0.05);PMNCD64水平感染组为(33.39±9.44)MFI、非感染组为(13.73±4.67)MFI、正常组为(7.01±2.98)MFI,差异有统计学意义(P<0.05);sCD86水平感染组为(756.87±161.52)U/ml,正常组为(561.12±104.47)U/ml,差异有统计学意义(P<0.05),与非感染组(662.26±139.98)U/ml比较,3组差异无统计学意义;CyPA水平感染组为(2.05±0.39)μg/L、正常组为(0.951±0.05)μg/L,差异有统计学意义(P<0.05),与非感染组(1.81±0.19)比较差异无统计学意义,非感染组与正常组比较差异无统计学意义;ANC、PMNCD64、sCD86水平胃肠疾病组及肝胆疾病组阳性率分别为72.00%、75.00%、68.00%,71.43%、68.00%、64.00%,创伤急诊组分别为96.30%、85.19%、70.37%,差异有统计学意义(P<0.05),CyPA水平胃肠疾病组与肝胆疾病及创伤急诊组阳性率分别为52.00%、53.57%及55.56%,差异无统计学意义。结论患者ANC水平测定对临床了解细菌感染的意义较大,创伤急诊手术后切口细菌感染率明显高于余两组基础疾病组,提示尤应重视术后切口细菌感染的预防控制。
OBJECTIVE To discuss the changes of peripheral blood inflammatory indicators of wound infection patients in general surgery and provide the basis for the prevention and control of wound infections in the laboratory.METHODS 162 patients enrolled from January 2006 to May 2011 in general surgery were divided into 2 groups according to the wound infections： infected group （80 cases） and non-infected group （82 cases）. 80 patients withwound infections were divided into 3 groups： acute trauma group （n= 27）,gastrointestinal disease group （n =25）,hepatobiliary disease group （n= 28）. The 82 patients in the non-infected group were divided into 3 groups：acute trauma group （n= 27） , gastrointestinal disease group （n = 25） , hepatobiliary disease group （n= 30）. 80healthy volunteers were the control group. The peripheral blood ANC and PMNCD64 levels were determined withautomated blood cell counting method and flow cytometry, and the serum sCD86 and CyPA levels were determinedwith ELISA technique. RESULTS The ANC levels in the infected group, noninfected group and normal roupwere （16. 73± 6. 73）×10^9/L, （5. 98. ±2. 56）×10^9/L,（4. 6 ± 1.27）×10^9/L respectively,with significantdifference between them （P〈C0. 05）; the PMNCD64 levels in the infected group, non-infected group and normalgroup were（33. 39 ± 9. 44） MFI,（13. 73 ± 4. 67） MFI,（7. 0l±2. 98） MFI respectively, with significant differencebetween them（P〈0. 05）; The sCD86 levels in the infected group, normal group and non-infected group were（756. 87± 161. 52）U/ml,（561. 12± 104.47） U/ml and（662. 26 ± 139. 98） U/ml respectively, showing no signifi-cant difference between them; the level of CyPA in the infected group and normal group were（2. 05±0. 39）μg/Land（0. 951 ±0. 05）μg/L respectively？ showing significant difference between them （P〈0. 05） ; but showing nosignificant difference when comparing with the non-infected group （1. 81 ±0. 19）. There was no significant difference of level of CyPA between the non-infected group and normal group. The positive rates of ANC,PMNCD64and sCDge in the gastrointestinal disease group and the hepatobliliary disease group were 72. 00%,75. 00%,68. 00%,71. 43%, 68. 00%, 64. 00% respectively; those of the acute trauma group were 96. 30%,85. 19%,70. 37% respectively, showing significant difference （P〈0. 05）. The positive rates of CyPA level in the gastroin-testinal disease group,hepatobliliary disease group and acute trauma group were 52. 00%,53. 57% and 55. 56%respectively, showing no significant difference. CONCLUSION The ANC level of patients is of great clinical valuefor understanding the bacterial infections. The bacterial infection rate of the wound after trauma emergency opera-tion is significantly higher than that of the other two basic disease groups, suggesting acute trauma patients shouldpay more attention to prevention and control of bacterial infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第17期4104-4106,共3页
Chinese Journal of Nosocomiology
基金
常熟市卫生局科研项目(CSWS 201206)
