腹部外伤患者术后感染与血清炎症因子的关联性研究

本研究旨在探讨外伤术后腹腔感染患者血清降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)和白细胞介素6 (IL-6)的水平变化与感染程度的相关性,为外伤术后腹腔感染临床治疗、抗菌药物应用提供依据。本研究选取我院2015年1月至2017年5月收治的腹部外伤手术患者150例,其中术后发生感染患者83例,未感染组,未发生感染患者67例,为非感染组。通过检测其术前术后及进行抗感染治疗后的PCT、TNF-α、CRP、IL-6水平,对腹腔感染标本进行菌种鉴定,并分析PCT、TNF-α、CRP、IL-6水平变化与腹腔感染的相关性,本研究发现,感染组患者术后各时间段血清PCT、TNF-α、CRP、IL-6水平明显较术前升高(p<0.05);且在术后12 h、24 h、72 h的PCT、TNF-α、CRP、IL-6水平明显高于未感染组(p<0.05);感染患者标本共检出76株不同的菌株,革兰阴性杆菌45株,革兰阳性菌22株,真菌9株;PCT、TNF-α、CRP在术后12 h、24 h、72 h检出感染的阳性率与病原学诊断结果相关性较高,血清IL-6则在术后72 h检出感染的阳性与病原学诊断相关性较高。本研究初步得出结论,临床检测血清PCT、TNF-α、CRP和IL-6均有助于鉴别是否存在外科腹腔感染,对抗菌药物的应用有一定的指导作用。

Study on the Relationship between Postoperative Infection and Serum Inflammatory Factors in Patients with Abdominal Trauma

The purpose of this study was to investigate the correlation between the changes of serum calcitonin(PCT), tumor necrosis factor-α(TNF-α), C-reactive protein(RP) and interleukin-6(IL-6) levels and the degree of infection in patients with postoperative abdominal infection in order to provide a basis for clinical treatment of abdominal infection after traumatic surgery and the application of antimicrobial medicines. In this study, 150 cases of patients with abdominal trauma who were treated in our hospital from January 2015 to May 2017 were selected, among which 83 cases of patients with postoperative infection were in the infection group, while 67 cases of patients without infection were in the non-infection group. The levels of PCT, TNF-α, CRP, and IL-6were measured before and after the operation and after anti-infection treatment. The strains of abdominal infection specimens were identified. Furthermore, the correlation between the changes of PCT, TNF-α, CRP, and IL-6 levels and abdominal infection was analyzed. The results showed that the levels of serum PCT, TNF-α,CRP and IL-6 were significantly higher in patients with infection group than those before operation(p<0.05);The PCT, TNF-α, CRP and IL-6 levels were significantly higher at 12 h, 24 h, 72 h after operation than those in the non-infection group(p<0.05);A total of 76 different strains were identified in infected patients, which included 45gram-negative bacilli, 22 gram-positive bacteria and 9 fungi;12, 24 and 72 h after operation, the positive rate of PCT, TNF-α and CRP was highly correlated with etiological diagnosis, and the positive rate of serum IL-6 was highly correlated with etiological diagnosis at 72 h after operation. This study preliminarily concluded that the clinical detection of serum PCT, TNF-α, CRP and IL-6 might be help to identify the presence of surgical celiac infection as well as to provide some guidances for the application of antimicrobial medicines.