摘要
目的分析C-反应蛋白(CRP)结合B超检查对外科手术后腹腔感染的诊断价值。方法选择医院行腹腔镜手术的患者146例,所有患者均于术前完善相关检查,分别于术后6h、12h、24h、36h、72h取静脉血检测CRP,并严密观察患者感染相关临床症状及体征,若患者出现疑似感染则行腹部B超检查,计算CRP阳性和B超检查阳性患者,判断腹腔感染的灵敏度、特异度和准确度。比较感染组和非感染组患者不同时间段CRP水平。对感染病原菌进行培养与鉴定。结果 146例患者术后病原学阳性18例,感染率12.33%。18例感染患者共检出病原菌28株,其中革兰阴性菌15株占53.57%,革兰阳性菌11株占39.29%,真菌2株占7.14%。术后12h、24h、36h、72h感染组患者CRP水平高于非感染组(P<0.05)。术后12h患者CRP指标水平联合B超筛查术后腹腔感染的灵敏度为72.22%,特异度为97.66%,准确度为94.52%。结论腹腔镜术后患者医院感染率较高,术后12hCRP指标水平联合B超筛查腹腔感染特异度和准确度较高,具有较高的临床价值。
OBJECTIVE To analyze the value of C-reactive protein(CRP)combined with B ultrasonography in diagnosis of postoperative abdominal infection.METHODS A total of 146 patients who received laparoscopic surgery in the hospital were enrolled in the study,all of the enrolled patients underwent the related examinations before the surgery,the venous blood specimens were collected after the surgery for 6,12,24,36 and 72 hours so as to detect the CRP,the infection-related clinical symptoms and signs were closely monitored,the patients who had suspected infection received the B ultrasonography,the patients who were positive for CRP and B ultrasonography were calculated.The sensitivity,specificity and accuracy in the diagnosis of abdominal infection were determined,the CRP levels were compared between the infection group and the non-infection group in different time periods,and the pathogens were isolated and identified.RESULTS Of the 146 patients,18 were etiologically positive after the surgery,with the infection rate 12.33%.Totally 28 strains of pathogens were isolated form the 18 patients with infection,15(53.57%)of which were gram-negative bacteria,11(39.29%)were gram-positive bacteria,and 2(7.14%)were fungi.The CRP levels of the infection group were significantly higher than those of the non-infection group after the surgery for 12,24,36 and 72 hours(P<0.05).The sensitivity of the CRP combined with B ultrasonography was 72.22%in screening of the abdominal infection after the surgery for 12 hours,the specificity97.66%,the accuracy 94.52%.CONCLUSION The incidence of postoperative nosocomial infection is high in the patients undergoing the laparoscopic surgery.The accuracy and specificity of the CRP combined with B ultrasonography are high in the screening of the abdominal infection after the surgery for 12 hours,and it has high clinical value.
作者
张万莉
罗璐
郭令飞
刘凯
李廷超
屈天银
张瑜
罗勇
ZHANG Wan-li;LUO Lu;GUO Ling-fei;LIU Kai;LI Ting-chao;QU Tian-yin;ZHANG Yu;LUO Yong(The First People's Hospital of Zunyi,Zunyi,Guizhou 563002,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第1期102-105,共4页
Chinese Journal of Nosocomiology
基金
贵州省合肥市科技计划基金资助项目(遵市科合社字2015-12号)
关键词
术后腹腔感染
C-反应蛋白
B超检查
灵敏度
特异度
临床价值
Postoperative abdominal infection
C-reactive protein
B ultrasonography
Sensitivity
Specificity
Clinical value
