髋关节假体感染的实验室与临床诊断对比研究

发布时间：2018-06-02 02:50

本文选题：C-反应蛋白 + 血沉　；参考：《中华医院感染学杂志》2015年02期

【摘要】：目的评价C-反应蛋白(CRP)、血沉(ESR)和术中冰冻切片单独及联合应用对诊断髋关节假体周围感染的作用,以降低漏诊率。方法对2006-2012年收治的髋关节置换翻修的患者进行回顾性分析,以CRP、ESR和术中冰冻切片作为诊断假体周围感染的标准,其中任意两项为阳性者即为感染,结合假体感染的"金标准",采用免疫浊度法测定CRP,ESR采用Westergren法测定,术中冰冻切片采用Feldman标准。结果 CRP的灵敏性、特异性、准确性分别为79.17%、87.50%、83.24%;ESR的灵敏性、特异性、准确性分别为81.94%、93.75%、85.16%;术中冰冻切片的灵敏性、特异性、准确性分别为86.11%、89.58%、87.22%;联合诊断的灵敏性、特异性、准确性分别为97.22%、95.83%、96.47%。结论将CRP、ESR和术中冰冻切片联合起来诊断髋关节假体周围感染可明显提高确诊率。
[Abstract]:Objective to evaluate the role of C- reactive protein (CRP), erythrocyte sedimentation (ESR) and intraoperative frozen section in the diagnosis of periprosthetic infection of the hip prosthesis in order to reduce the missed diagnosis rate. Methods a retrospective analysis of 2006-2012 years of hip arthroplasty was performed. CRP, ESR, and intraoperative frozen section were used as the criteria for the diagnosis of periprosthetic infection. Two of the two positive ones were infected. Combined with the "gold standard" of the prosthesis infection, the immune turbidimetric method was used to determine CRP, ESR was determined by Westergren, and the frozen section in the operation was Feldman standard. The sensitivity, specificity and accuracy of CRP were 79.17%, 87.50%, 83.24%, and the sensitivity, specificity and accuracy of ESR were 81.94 respectively. %, 93.75%, 85.16%; the sensitivity, specificity and accuracy of intraoperative frozen section were 86.11%, 89.58%, 87.22%, respectively, and the sensitivity, specificity and accuracy of combined diagnosis were 97.22%, 95.83%, respectively. Conclusion the combined diagnosis of CRP, ESR and intraoperative frozen section for the diagnosis of hip prosthesis infection could significantly improve the diagnosis rate.
【作者单位】：南阳市中心医院骨科二病区;
【基金】：河南省卫生厅立项基金资助项目(HW-2010B-017)
【分类号】：R318.17

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