血清生物学指标在脊柱内固定融合术后感染患者中的诊断价值  

Value of serum biological markers in the diagnosis of infections after spinal fusion

作　　者：林利兴[1] 刘良乐[1] 何少奇[1] 汤呈宣[1] 戴鸣海[1] 

机构地区：[1]瑞安市人民医院脊柱外科,浙江温州325200

出　　处：《中华医院感染学杂志》2017年第15期3522-3524,3536,共4页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生基金资助项目(2014KYB315)

摘　　要：目的探讨血清生物学指标在脊柱内固定融合术后感染患者中的诊断价值,旨在为临床诊断和治疗提供一定参考意义。方法选择2014年6月-2016年6月期间于医院收治的因胸腰椎骨折、腰椎滑脱症、腰椎间盘突出症等行脊柱内固定融合术术后感染患者78例为观察组,选自同期收治的未感染患者100例为对照组;分析术后感染患者病原菌分布、耐药性及两组患者临床指标。结果术后感染78例共培养病原菌69株,以革兰阴性菌为主,共49株占71.01%;铜绿假单胞菌、肺炎克雷伯菌对庆大霉素和环丙沙星耐药率较高,均>80.00%;观察组血清C-反应蛋白(CRP)、碱性磷酸酶(ALP)、肌酸激酶(CK)均显著高于对照组,差异有统计学意义(P<0.05)。结论血清生物学指标CRP、ALP、CK对脊柱内固定融合术后感染患者具有重要诊断价值,且术后感染以革兰阴性菌为主。OBJECTIVE To investigate the value of serum biological markers in the diagnosis of infections after spinal fusion,so as to provide some references for clinical diagnosis and treatment.METHODS A total of 78 cases of patients with infections from our hospital from Jun.2014 to Jun.2016 for thoracolumbar fracture,lumbar spondylolisthesis,lumbar disc herniation and spinal fusion surgery were selected as observation group,and another 100 cases of uninfected patients during the same period were selected as control group.Distribution of pathogens in patients with infections after operation,drug resistance and clinical indexes between the two groups were compared.RESULTS Totally 69 strains of pathogenic bacteria were cultured in 78 cases of patients with postoperative infections,which were mainly 49 strains of gram-negative bacteria,accounting for 71.01% .The resistant rates of Pseudomonas aeruginosa and Klebsiella pneumoniae to gentamicin and ciprofloxacin were high,which were all higher than 80.00% .The serum levels of CRP,ALP,and CK of observation group were significantly higher than those of control group（P〈0.05）.CONCLUSIONCRP,ALP and CK have important diagnostic value in the diagnosis of infection after spinal fusion,and the gram-negative bacteria are the main pathogens of infections after the operation.

关 键 词：血清生物学 脊柱内固定融合术 感染 诊断价值 

分 类 号：R687.3[医药卫生—骨科学]