摘要
目的了解术后感染对血红细胞沉降率(ESR)、C-反应蛋白(CRP)、白细胞(WBC)计数早期变化影响以及不同手术创伤情况下上述指标的变化规律,探讨上述指标在脊柱术后感染诊断中的临床意义。方法选取本院2010年9月—2012年1月脊柱手术无感染病人204例(非感染组),术前及术后1、2、5d常规采集外周血,检测CRP、ESR、WBC,并与本院2006年1月—2012年1月脊柱外科术后感染病人(感染组)33例的检测结果进行比较。同时将非感染病人根据术中出血量分为A1组(出血量≤400mL,120例)及A2组(出血量>400mL,84例),根据手术时间分为B1组(手术时间≤180min,121例)及B2组(手术时间>180min,83例),进行对比分析。结果各组术后CRP、ESR、WBC水平均较术前增高,差异有显著性(F=25.87～275.93,q=3.17～35.16,P<0.05)。术后CRP、ESR、WBC水平比较,非感染组<感染组,A1组<A2组,B1组<B2组。结论脊柱术后病人CRP、ESR、WBC水平有不同程度的增高,术后并发感染和手术创伤较大的病人上述指标升高更加明显。在脊柱术后感染的诊断中CRP、ESR价值较高,WBC的价值较低。
Objective To study the effects of postoperative infection on early changes of erythrocyte sedimentation rate （ESR）, C-reactive protein （CRP） value and white blood cell （WBC） count, the rule of changes of the above parameters, and ex- plore the clinical significance of the above parameters in the diagnosis of infection after spinal surgery. Methods From Sep. 2010 to Jan. 2012, 204 patients underwent spinal surgery without postoperative infection were selected （non infected group）, ESR, CRP and WBC were measured before surgery and 1, 2, and 5 days after surgery. The results were compared with 33 patients with postoperative infection, who underwent spinal surgery from Jan. 2006 to Jan. 2012. According to blood loss at surgery, non- infected patients were divided into group A1 （^-~400 mL） and A2 （2~400 mL） ; and according to operation time, they were divided into group B1 （~180 min） and B2 （2〉180 min）. A contrast analysis was done among them. Results The CRP, ESR and WBC increased in all the groups after operation （F=25.87 275.93,q=3.17-35. 16,P〈0.05）. And CRP,ESR and WBC levels in in fection group were higher than that in non-infected group, that in group A2 were higher than that in group A1, and B2 higher than B1. Conclusion After spinal surgery, the CRP, ESR and WBC levels of patients increase to a certain extent,for those with postoperative infection or with major surgical trauma, the elevation of the above parameters is more obvious. The diagnostic value of CRP and ESR is higher than WBC in the diagnosis of infection after spinal surgery.
出处
《青岛大学医学院学报》
CAS
2012年第4期367-370,共4页
Acta Academiae Medicinae Qingdao Universitatis
关键词
脊柱
手术后并发症
外科伤口感染
血沉
C反应蛋白质
白细胞计数
spine
postoperative complications
surgical wound infection
blood sedimentation
C-reactive protein
leu-kocyte count
作者简介
邓哲（1986一），男，在读硕士研究生
[通讯作者]张国庆（1964），男，主任医师，硕士生导师
