摘要
目的探讨高龄患者全髋关节置换术后肺部感染与血清炎性因子的变化,为术后肺部感染的防治提供参考。方法选取2015年1月-2017年12月在医院行全髋关节置换术的高龄患者120例,观察患者术后肺部感染发生情况,采集感染患者痰液标本行细菌培养、分离及鉴定,检测患者术前、术后3d血清肿瘤坏死因子α(TNF-α)、白细胞介素-1、2、6、8、10(IL-1、IL-2、IL-6、IL-8、IL-10)、C-反应蛋白(CRP)等炎性因子水平。结果术后21例患者发生肺部感染,感染率为17.50%,共分离病原菌23株,其中革兰阴性菌15株、革兰阳性菌8株。患者术后3d血清TNF-α、IL-1、IL-6、IL-8、IL-10、CRP均高于术前,IL-2低于术前,比较差异有统计学意义(P<0.05);术后肺部感染与未感染患者术前血清炎症因子比较差异无统计学意义;术后3d肺部感染患者血清TNF-α、IL-1、IL-6、IL-8、IL-10、CRP分别为(35.16±14.44)pg/ml、(74.35±21.34)pg/ml、(98.05±34.62)pg/ml、(62.46±21.81)pg/ml、(35.23±7.90)pg/ml、(31.72±3.45)g/L,高于未感染患者(P<0.05),IL-2为(143.68±42.14)pg/ml低于未感染患者(P<0.05)。结论全髋关节置换高龄患者术后容易发生肺部感染,术后早期检测血清炎性因子水平有助于预测及诊断肺部感染。
OBJECTIVE To explore the correlation between the postoperative pulmonary infection and the serum inflammatory factors of the elderly patients undergoing total hip arthroplasty so as to provide guidance for prevention and treatment of the postoperative pulmonary infection.METHODS A total of 120 elderly patients who underwent the total hip arthroplasty in hospitals from Jan 2015 to Dec 2017 were enrolled in the study,the incidence of postoperative pulmonary infection was observed,the sputum specimens were collected from the patients with the infection,the bacterial culture,isolation and identification were carried out,and the levels of serum inflammatory factors,including tumor necrosis factorα(TNF-α),interleukin-1,2,6,8,10(IL-1,IL-2,IL-6,IL-8,IL-10)and C-reactive protein(CRP)were determined before the surgery and after the surgery for 3 days.RESULTS Totally 21 patients had postoperative pulmonary infection,with the infection rate 17.50%.A total of 23 strains of pathogens were isolated,15 of which were gram-negative bacteria,and 8 were gram-positive bacteria.The levels of serum TNF-α,IL-1,IL-6,IL-8,IL-10 and CRP of the patients were higher after the surgery for 3 days than before the surgery,while the IL-2 level was significantly lower after the surgery for 3 days than before the surgery(P<0.05).There were no significant differences in the levels of serum inflammatory factors between the patients with postoperative pulmonary infection and the patients without infection before the surgery;the levels of serum TNF-α,IL-1,IL-6,IL-8,IL-10 and CRP of the patients with pulmonary infection were respectively(35.16±14.44)pg/ml,(74.35±21.34)pg/ml,(98.05±34.62)pg/ml,(62.46±21.81)pg/ml,(35.23±7.90)pg/ml and(31.72±3.45)g/L after the surgery for 3 days,significantly higher than those of the patients without infection(P<0.05);the IL-2 level of the patients with pulmonary infection was 143.68±42.14)pg/ml,significantly lower than that of the patients without infection(P<0.05).CONCLUSIONThe elderly patients are prone to have pulmonary infection after the total hip arthroplasty,and the postoperative detection of the serum inflammatory factors in early stage may facilitate the diagnosis of pulmonary infection.
作者
王君华
刘淑霞
陈月琴
宁向君
王锐瑞
张艳培
WANG Jun-hua;LIU Shu-xia;CHEN Yue-qin;NING Xiang-jun;WANG Rui-rui;ZHANG Yan-pei(Luohe Medical College,Luohe,Henan 462001,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第9期1396-1399,共4页
Chinese Journal of Nosocomiology
基金
河南省教育厅科学技术研究重点基金资助项目(152102819931)
关键词
全髋关节置换术
高龄
肺部感染
炎性因子
Total hip arthroplasty
Elderly
Pulmonary infection
Inflammatory factor
