摘要
目的:探讨脊柱手术后切口感染患者血清炎症因子变化及临床意义。方法:选取2018年9月至2019年9月脊柱手术后患者658例,所有患者均检测血清炎症因子(高敏C-反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、白介素8(IL-8))水平,并通过细菌培养评估切口感染情况,分析炎症因子对脊柱手术后切口感染的临床意义。结果:658例脊柱手术后患者中,切口感染者有90例,感染率为13.68%;感染者术后1,3 d血清hs-CRP,TNF-α,IL-8水平明显高于无感染者,差异有统计学意义(P<0.05);ROC曲线分析显示,在评估脊柱手术后切口感染的敏感度、特异度、准确度中,hs-CRP>20.4 mg/L时为84.44%,92.26%和91.19%,TNF-α>1.8 ng/mL时为82.22%,93.31%和91.79%,IL-8>11.5 pg/mL时为80.00%,91.55%和89.97%,hs-CRP,TNF-α,IL-8联合时为97.78%,98.59%和98.48%,hs-CRP,TNF-α,IL-8联合时明显高于hs-CRP,TNF-α,IL-8单独时,差异有统计学意义(P<0.05)。结论:hs-CRP,TNF-α,IL-8等血清炎症因子变化与脊柱手术后切口感染有关,可作为评估患者切口感染的重要指标,且三者联合时评估价值更高。
Objective:To explore the change and clinical significance of serum inflammatory factors in patients with incision infection after spinal surgery. Methods:658 patients who underwent spinal surgery in our hospital from September 2018 to September 2019 were selected,the serum levels of inflammatory factors(high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-8(IL-8)) were detected in all patients,and the incision infection was evaluated by bacterial culture. The clinical significance of inflammatory factors on incision infection after spinal surgery was analyzed. Results:Among the 658 patients who underwent spinal surgery 90 patients had incision infection,and the infection rate was 13.68%. The serum levels of hs-CRP,TNF-α and IL-8 in infected patients at 1 and 3 days after operation were significantly higher than those in non-infected patients,the difference was statistically significant(P<0.05). The ROC curve analysis showed that,in the sensitivity,specificity and accuracy of evaluating incision infection after spinal surgery the hs-CRP>20.4 mg/L were 84.44%,92.26%,91.19%,the TNF-α>1.8 ng/mL were 82.22%,93.31%,91.79%,the IL-8 > 11.5 pg/mL were 80.00%,91.55%,89.97%,the hs-CRP,TNF-α and IL-8 combined were 97.78%,98.59%,98.97%. The hs-CRP,TNF-α and IL-8 combined were significantly higher than the hs-CRP,TNF-α and IL-8 alone,the difference was statistically significant(P<0.05). Conclusion:The change of serum inflammatory factors such as hs-CRP,TNF-α and IL-8 are related to incision infection after spinal surgery,which can be used as the important index for evaluating incision infection in patients,and the combination of them has higher evaluation value.
作者
董锡亮
杨子斌
吕乔
DONG Xiliang;YANG Zibin;LYU Qiao(The First Department of Orthopedics,Dali City People's Hospital of Yunnan Province,Dali 671000,Yunnan China)
出处
《中国中医骨伤科杂志》
CAS
2020年第7期43-46,共4页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
关键词
脊柱手术
切口感染
炎症因子
临床意义
spinal surgery
incision infection
inflammatory factors
clinical significance
