C-反应蛋白对普外科患者手术后腹腔感染性并发症的预测效果  

Predictive effect of C reactive protein on complications of abdominal infection after surgery in general surgery department

作　　者：夏恒 陈福森 孙玲玲 邱海江 王苗峰 郑迪峰 

机构地区：[1]绍兴市中心医院普外科,浙江绍兴312000

出　　处：《中华医院感染学杂志》2017年第11期2539-2542,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨C-反应蛋白(CRP)对普外科患者手术后腹腔感染性并发症的预测效果,为临床预防治疗提供参考。方法回顾性分析医院2010年1月-2015年12月1 200例普外科手术患者病历资料,根据是否发生腹腔感染性并发症将患者分为感染组(腹腔感染)和未感染组,按照倾向性评分匹配法,将腹腔感染性并发症患者∶无感染患者=1∶2的比例筛选一般资料无差异的患者,符合纳入标准的患者642例,其中感染组患者214例,未感染组患者428例,统计两组患者的年龄、手术史、手术时间、术中出血量、术中输血等,采用免疫比浊法检测所有患者手术前后CRP水平,对感染组患者的痰、分泌物、穿刺液及尿、血等进行细菌培养和鉴定。结果 214例腹腔感染患者中共检测出病原菌253株,其中革兰阴性菌205株占81.03%,以肺炎克雷伯菌和大肠埃希菌所占比例最高,革兰阳性菌48株占18.97%,以金黄色葡萄球菌所占比例最高,感染组和未感染组患者术后1d、3d中性粒细胞百分比和白细胞计数比较差异无统计学意义,但感染组患者CRP水平显著高于对照组,差异有统计学意义(P<0.05)。结论 CRP对普外科患者手术后腹腔感染性并发症具有较好的预测效果与临床应用价值。OBJECTIVE To investigate the predictive effect of C reactive protein （CRP） on complications of abdominal infection in general surgery department after the surgery,so as to provide references for clinical prevention and treatment.METHODS Clinical data of 1200 cases of patients from department of general surgery from Jan.2010 to Dec.2015 were retrospectively analyzed.According to whether the occurrence of abdominal infection complications,patients were divided into infection group （intraperitoneal infection） and non infected group.According to the propensity score matching method,patients with no difference in general were screened by the ratio of 1 ∶ 3 of patients with the abdominal infection complications and non infected patients,and 642 patients met the inclusion criteria,including 214 patients in infection group and 428 patients in non-infected group.The age,operation history,operation time,amount of intraoperative bleeding,intraoperative blood transfusion,and C reactive protein level before and after surgery detected by immunoturbidimetry of the two groups of patients were statistically analyzed.The sputum,secretion,puncture fluid,and urine and blood in the infection group were cultured and identified.RESULTS Arnong 214 cases of abdominal infection,253 strains of pathogenic bacteria were detected,including 205 cases of gram-negative bacteria,accounting for 81.03 %,which were mainly Klebsiella pneumoniae and Escherichia coli with the highest proportions,and 48 cases of gram-positive bacteria,accounting for 18.97%,of which Staphylococcus aureus accounted for the highest proportion.There was no significant difference in neutrophil percentage and white blood cell count between infection group and non-infected group at 1 and 3 d after operation,but the level of CRP in infection group was significantly higher than that in control group,and the difference was significant （P〈 0.05）.CONCLUSION C reaction protein has a good prediction effect and clinical value of complications of abdominal infection aft

关 键 词：C反应蛋白 普外科 腹腔感染性并发症 

分 类 号：R446[医药卫生—诊断学]