腰椎手术后血清C-反应蛋白与血沉定量分析及临床意义  

Quantitative analysis of C reactive protein levels and erythrocyte sedimentation rate after lumbar surgery

作　　者：高苏宁[1] 陈长玉[1] 赵红军[1] 邹晓波[1] 韩晓光[1] 

机构地区：[1]解放军第81医院骨科

出　　处：《中国脊柱脊髓杂志》1998年第1期13-16,共4页Chinese Journal of Spine and Spinal Cord

摘　　要：目的：为４种腰椎术式术后血清Ｃ－反应蛋白（ＣＲＰ）提供临床反应参数，并与红细胞沉降率（ＥＳＲ）做对比，探讨二者在腰椎术后体现的临床意义。方法：对开窗髓核摘除组（４３例）、侧椎管减压组（２８例）、全椎板切除组（１３例）和后路减压植骨组（９例）四种常用腰椎术式病人术后血清ＣＲＰ进行１～３５ｄ动态监测，并与血沉做对照分析。结果：所有病人术后ＣＲＰ值均升高，２～３ｄ达到峰值，１０ｄ后回落至正常水平。各组术式ＣＲＰ值存在差异（Ｐ＜０．０１）。与ＥＳＲ相比，ＣＲＰ高峰出现早，回落周期短，稳定性好。结论：腰椎术后ＣＲＰ持续性或二次升高者要考虑感染存在。与ＥＳＲ相比较，ＣＲＰ具有灵敏性高，准确性强之优点，可望作为早期判断腰椎术后感染的重要指标。Objective:The clinical parameters of C reactive protein(CRP) were given for the standardized lumbar surgical procedures of fenestrational discectomy,lateral canal decompression,total laminectomy and posterior decompression with fusion.The clinical significance of serum CRP as an early detector of postoperative infections was discussed and compared with erythrocyte sedimentation rate(ESR).Methods:Serum CRP and ESR were continuosly monitored and recorded for the patients of discetomy(43 cases),lateral canal decompression(28 cases),total laminectomy(13 cases),and posterior decompression with fussion(9 cases) from 1 to 35 days.The comparation of CRP and ESR values was analyzed statistically.Results:In all the patients,CRP levels increased postoperatively,reaching the peak in 2 to 3 days,and reduced to normal(<12mg/L) within 10 days.The maximal amplitude of CRP levels varied between the four different procedures.The CRP response was relative to the amount and type of tissues damaged at surgery.The peak of CRP occurred early and the decline of the peak was faster and regular after the surgery.Conclusion:Comparing with ESR,CRP values show the advantage of good sensitivity and accuracy in the nomalization time during the postoperative period.Infestion complications should be reasonably considered if serm CRP levels are persisting elevated or a consequential rise after spinal surgery. Authors address\ Orthopedic Department,the 81st Hospital of PLA,Nanjing,Jiangsu,210002

关 键 词：C-反应蛋白 红细胞沉降率 腰椎手术 感染 

分 类 号：R687.3[医药卫生—骨科学] R619.3[医药卫生—外科学]