血清降钙素原在伴有内固定及假体置入的骨科手术后切口感染早期诊断中的意义  

Significance of serum procalcitonin in early diagnosis of incision infection of orthopedic surgery with fixation and implants

作　　者：侯润宇 张志诚[2] 李放[2] 赵广民[2] 高维涛[2] 孙天胜[2] 

机构地区：[1]解放军医学院,北京100853 [2]北京军区总医院骨科,北京100853

出　　处：《检验医学与临床》2014年第10期1301-1303,共3页Laboratory Medicine and Clinic

基　　金：国家自然科学基金资助项目(81200960)

摘　　要：目的探讨血清降钙素原(PCT)在伴有内固定及假体置入的骨科手术后切口感染早期诊断中的意义。方法对术后疑似存在手术切口感染的患者(124例)进行血清PCT检测,同时检测患者的白细胞(WBC)、红细胞沉降率(ESR)、C反应蛋白(CRP)水平,分析3个指标在发生感染与未发生感染患者之间的差异。结果术前各项指标在感染与非感染患者间的差异均无统计学意义(P>0.05),术后感染与非感染患者的WBC、ESR水平比较,差异无统计学意义(P>0.05),CRP、PCT水平两组比较差异有统计学意义(P<0.05)。感染患者术后CRP及PCT水平明显高于非感染患者,并且PCT在敏感度及特异度上均好于CRP。结论 PCT是术后早期诊断手术切口感染的重要诊断指标,虽然WBC、ESR、CRP等指标是判断术后手术切口感染的首选方法,但PCT有着更好的敏感性及特异性,对术后手术存在疑似切口感染的患者进行血清PCT检查很有必要。Objective To explore the significance of serum procalcitonin （PCT ） in early diagnosis of incision infection of orthopedic surgery with fixation and implants .Methods A total of 124 patients with suspected postoper-ative incision infection were detected for serum PCT ,white blood cells （WBC） ,erythrocyte sedimentation rate （ESR） and C reaction protein （CRP） .Difference of theses indexes were compared between patients with or without infec-tions .Results Levels of these indexes ,detected before operation ,were without statistical difference between patients with or without post-operative infections （P〉0 .05） .Post-operative levels of WBC and ESR were without statistical difference between patients with or without post-operative infections （P〉0 .05） ,but the difference of CRP and PCT levels were significant （P〈0 .05） .Post-operative levels of CRP and PCT in patients with infections were higher than patients without infections ,and the sensitivity of PCT was superior to CRP .Conclusion Serum PCT could be very helpful for early diagnosis of post-operative incision infection ,with better sensitivity and specificity than WBC ,ESR and CRP .

关 键 词：血清降钙素原 骨科手术 术后感染 C反应蛋白 红细胞沉降率 

分 类 号：R619.3[医药卫生—外科学]