摘要
目的联合动态检测骨科内置物术前术后早期血白细胞(WBC)、红细胞沉降率(ESR)、超敏C反应蛋白(hsCRP)、降钙素原(PCT)的浓度,定量分析其变化规律,探讨其临床意义。方法选取骨科行内置物手术切口甲级愈合患者128例,动态监测其血清WBC、ESR、hsCRP、PCT浓度在术前、术后第1、2、3、5、7天的数值,定量分析其变化规律。结果术后第1天WBC值升高达到峰值,第2天后逐渐下降,术后第5天恢复到正常范围;ESR在术后缓慢上升,到第5天升高到峰值,后下降;hsCRP术后升高,第2天时达到最大峰值,后逐渐下降;PCT数值则在术后无明显变化。结论骨科内置物术后WBC、ESR、hsCRP、PCT浓度的变化有各自的规律,违反规律的异常升高或降低后再次升高则要考虑感染存在。联合动态监测WBC、ESR、hsCRP、PCT的浓度变化可以指导骨科内置物术后早期感染的诊断。
[Objective] To discuss the clinical significance and analyse the change rules of white blood cell （WBC）, erythrocyte sedimentation rate （ESR）, hypersensitivity C-reactive protein （hsCRP）, procalcitonin （PCT） by continuous monitoring in the early period after orthopedic implant surgery. [Methods] Totally 128 cases who accept implant surgery with good wound healing were selected, the numerical levels ofWBC, ESR, hsCRP, PCT were continuously monitored before operation and at the 1st, 2nd, 3rd, 5th, 7th day after operation, and the change rules were quantitatively analyzed. [Results] The WBC level rose to the peak value at the 1st day after operation, the level declined at the 2nd day, and at the 5th day, it was in the normal range. The level of ESR rose slowly after operation, it reached to the peak at the 5th day and then declined. The level of hsCRP sharply rose, it reached to the crest value at the 2nd day and then declined. The change in PCT level was not significant after operation. [Conclusion] There were change rules respectively in the level of WBC, ESR, hsCRP, PCT after operation. When the quantity rose abnormally or rose again after decrease, it suggested the possibility of infection. The continuous combined monitoring of WBC, ESR, hsCRP, PCT can guide the diagnosis and treatment for the infection in the early period of post-operation of orthopedic implant surgery.
出处
《中国医学工程》
2017年第4期14-17,共4页
China Medical Engineering
基金
湖南省医药卫生科研计划课题(B2014-148)
关键词
骨科内置物
变化规律
红细胞沉降率
超敏C反应蛋白
降钙素原
orthopedic implant
change rules
erythrocyte sedimentation rate
hypersensitivity c-reactive protein
procalcitonin
