脊柱手术后切口感染患者血清炎症因子变化及临床意义

发布时间：2018-07-27 11:40

【摘要】：目的分析脊柱手术切口感染患者的血清炎症因子变化特点及临床价值。方法选取2015年6月-2016年9月期间于医院接受脊柱手术的626例患者,将术后发生切口感染的82例患者作为切口感染组(根据感染深度分为浅部感染患者49例和深部感染患者33例),并选取85例未出现切口感染患者作为切口未感染组,抽取同期80名体检正常人作为健康组;统计分析切口感染患者病原菌分布,分析组间血清炎性因子表达的差异。结果82例切口感染患者,感染率为13.10%;感染患者标本中共分离获得病原菌198株,以革兰阴性菌为主,共134株占67.68%;切口感染组血清白介素-6(IL-6)、白介素-8(IL-8)、白介素-18(IL-18)、降钙素原(PCT)、中性粒细胞绝对值(ANC)、高敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)及干扰素-γ(INF-γ)水平高于切口未感染组和健康组(P0.05),切口未感染组的血清IL-6、IL-8、IL-18、PCT、ANC、hs-CRP及TNF-α高于健康组(P0.05);浅部感染患者血清IL-6、IL-8、IL-18、PCT、INF-γ、ANC、hs-CRP、TNF-α低于深部感染患者(P0.05)。结论脊柱手术后切口感染主要致病菌为革兰阴性菌,在发生切口感染后患者的血清促炎症因子显著升高,且血清促炎性因子升高幅度可能与感染深度有密切关联。
[Abstract]:Objective to analyze the characteristics and clinical value of serum inflammatory factors in patients with spinal surgical incision infection. Methods to select 626 patients who received spinal surgery in the hospital during September -2016 year and September as the incision infection group (49 cases and deep feeling according to the depth of infection according to the depth of infection. " 33 cases were infected, and 85 cases of uninfected incisional infection were selected as non infection group and 80 normal persons were selected as healthy group for the same period. The distribution of pathogenic bacteria in patients with incision infection was analyzed and the difference of expression of serum inflammatory factors between the groups was analyzed. The results were 82 cases of incisional infection, the infection rate was 13.10%, and the specimens of infected patients were divided into two groups. 198 strains of pathogenic bacteria were obtained, which were mainly Gram-negative bacteria, which accounted for 67.68%; serum interleukins -6 (IL-6), interleukin -8 (IL-8), interleukins -18 (IL-18), calcitonin proto (PCT), neutrophil absolute value (ANC), high sensitive C- reactive protein (hs-CRP), tumor necrosis factor alpha (TNF- alpha) and interferon gamma (INF- gamma) were higher than those of the incisional incision in the incision infection group. The serum IL-6, IL-8, IL-18, PCT, ANC, hs-CRP and TNF- alpha in the uninfected group were higher than those in the healthy group (P0.05), and the sera of the patients with superficial infection were lower than those of the deep infection. Conclusion the main pathogenic bacteria of the incision infection after spinal surgery were gram-negative bacteria, and the incision occurred in the incision after the spinal operation. The serum proinflammatory cytokines increased significantly after infection, and the increase of serum proinflammatory factors may be closely related to the depth of infection.
【作者单位】：南阳市第二人民医院疼痛科;
【分类号】：R687.3

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