甲状腺手术患者感染及炎性应激状态的研究  

Postoperative infections of patients with thyroid surgery and the inflammatory stress state

作　　者：张琼[1] 董钰英[1] 李铃芳[1] 方兴[2] 苏利花 

机构地区：[1]绍兴市人民医院乳腺甲状腺外科,浙江绍兴312000 [2]金华市人民医院医务科,浙江金华321000

出　　处：《中华医院感染学杂志》2016年第14期3246-3248,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医院可持续发展华润三九研究基金资助项目(2014ZHA-HRSJ212)

摘　　要：目的研究甲状腺患者术后感染发生率及炎性应激状态,为甲状腺患者术后感染的预防及监测提供依据。方法选取2014年1月-2015年10月于医院进行甲状腺手术1 860例患者为研究对象,将其中感染发生率及感染部位进行统计分析,并对部分感染患者术后1、3、5、7及10d的炎性应激指标进行检测与比较。结果 1 860例甲状腺手术患者中,共49例发生感染,感染率为2.63%,术后感染患者术后1、3、5、7及10d的血清炎性应激指标存在明显差异,术后3d血清促炎指标中的白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、白细胞介素8(IL-8)及肿瘤坏死因子α(TNF-α)表达水平分别为(3.78±0.40)pg/ml、(15.43±2.26)pg/ml、(17.66±2.46)pg/ml及(4.10±0.38)ng/ml,其均高于术后其他时间,血清抑炎指标及其他炎性相关指标也存在明显差异均有统计学意义(P<0.05)。结论甲状腺患者术后感染率较高,且术后感染患者围术期的炎性应激状态变化较大,应针对性监测及干预。OBJECTIVE To study the postoperative infection rate of patients with thyroid surgery and the inflammatory stress state,in order to provide evidence for the prevention and monitoring of postoperative infections of patients with thyroid surgery.METHODS A total of 1860 patients with thyroid surgery in our hospital from Jan.2014 to Oct.2015 were selected as the research object.The infection rates and infection sites of all the patients were respectively analyzed,and the inflammatory stress indexes of partial patients with infection at first,third,fifth,seventh and tenth day after the operation were detected and compared.RESULTS A total of 49 cases in 1 860 patients with thyroid surgery were with infection,and the infection rate was 2.63%.The serum inflammatory stress indexes of patients with postoperative infection at first,third,fifth,seventh and tenth day after the operation all had obvious differences,and the serum pro-inflammatory indexes including interleukin 1β（IL-1β）,Interleukin 6（IL-6）,interleukin 8（IL-8）and tumor necrosis factorα（TNF-α）levels at third day after the operation were respectively（3.78±0.40）pg/ml,（15.43±2.26）pg/ml,（17.66±2.46）pg/ml and（4.10±0.38）ng/ml,which were all significantly higher than those at other time after the operation,and the serum anti-inflammatory indexes and other inflammatory indexes significantly（P〈0.05）.CONCLUSIONThe postoperative infection rate of patients with thyroid surgery is high,and the change of inflammatory stress state of patients with postoperative infections are great,so it should be paid targeted monitoring and intervention.

关 键 词：甲状腺手术 术后感染 感染率 炎性应激状态 

分 类 号：R653[医药卫生—外科学]