C-反应蛋白对普外科患者手术后腹腔感染性并发症的预测效果

发布时间：2018-05-07 11:45

本文选题：C-反应蛋白 + 普外科　；参考：《中华医院感染学杂志》2017年11期

【摘要】：目的探讨C-反应蛋白(CRP)对普外科患者手术后腹腔感染性并发症的预测效果,为临床预防治疗提供参考。方法回顾性分析医院2010年1月-2015年12月1 200例普外科手术患者病历资料,根据是否发生腹腔感染性并发症将患者分为感染组(腹腔感染)和未感染组,按照倾向性评分匹配法,将腹腔感染性并发症患者∶无感染患者=1∶2的比例筛选一般资料无差异的患者,符合纳入标准的患者642例,其中感染组患者214例,未感染组患者428例,统计两组患者的年龄、手术史、手术时间、术中出血量、术中输血等,采用免疫比浊法检测所有患者手术前后CRP水平,对感染组患者的痰、分泌物、穿刺液及尿、血等进行细菌培养和鉴定。结果 214例腹腔感染患者中共检测出病原菌253株,其中革兰阴性菌205株占81.03%,以肺炎克雷伯菌和大肠埃希菌所占比例最高,革兰阳性菌48株占18.97%,以金黄色葡萄球菌所占比例最高,感染组和未感染组患者术后1d、3d中性粒细胞百分比和白细胞计数比较差异无统计学意义,但感染组患者CRP水平显著高于对照组,差异有统计学意义(P0.05)。结论 CRP对普外科患者手术后腹腔感染性并发症具有较好的预测效果与临床应用价值。
[Abstract]:Objective to investigate the predictive effect of C-reactive protein (CRP) on postoperative abdominal infectious complications in patients undergoing general surgery, and to provide reference for clinical prevention and treatment. Methods the medical records of 1,200 patients undergoing general surgery from January 2010 to December 2015 in our hospital were retrospectively analyzed. The patients were divided into infected group (abdominal infection) and non-infected group according to the incidence of intraperitoneal infectious complications. According to the tendency score matching method, the patients were divided into two groups. 642 patients with intraperitoneal infectious complications, including 214 patients in infection group and 428 patients in uninfected group, were selected by the ratio of 1: 2 to 1: 2. The age of the patients in the two groups was counted as follows: there were 642 patients who met the inclusion criteria, including 214 patients in the infection group, 428 patients in the uninfected group, and the age of the patients in the two groups. History of operation, time of operation, amount of intraoperative blood loss, intraoperative blood transfusion and so on. The levels of CRP in all patients before and after operation were detected by immunoturbidimetry. The sputum, secretion, puncture fluid, urine and blood of infected patients were cultured and identified. Results 253 strains of pathogenic bacteria were detected in 214 patients with intraperitoneal infection. Among them, 205 strains of Gram-negative bacteria accounted for 81.03 strains, among which Klebsiella pneumoniae and Escherichia coli accounted for the highest proportion, 48 strains of Gram-positive bacteria accounted for 18.97 strains, and Staphylococcus aureus accounted for the highest proportion. There was no significant difference in neutrophil percentage and leukocyte count between the infected group and the uninfected group on the 1st day after operation, but the CRP level in the infected group was significantly higher than that in the control group (P 0.05). Conclusion CRP has a good predictive effect and clinical application value for postoperative abdominal infectious complications in patients with general surgery.
【作者单位】：绍兴市中心医院普外科;
【分类号】：R619.3

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