骨折患者术后感染影响因素及血清Flt3L和Gas6诊断效果  

Influencing factors of postoperative infection in fracture patients and the diagnostic effect of serum Flt3L and Gas6

作　　者：张志韧 杨东辉 刘珂 周志成 轩中勋 ZHANG Zhi-ren;YANG Dong-hui;LIU Ke;ZHOU Zhi-cheng;XUAN Zhong-xun(Zhumadian Central Hospital,Henan Province,Zhumadian,Henan 463000,China;不详)

机构地区：[1]河南省驻马店市中心医院创伤骨科,河南驻马店463000 [2]河南省人民医院/郑州大学人民医院骨科,河南郑州450008

出　　处：《中华医院感染学杂志》2022年第12期1803-1807,共5页Chinese Journal of Nosocomiology

基　　金：河南省医学科技攻关计划省部共建基金资助项目(201701017)。

摘　　要：目的 分析血清Flt3配体(Flt3L)和生长停滞特异性蛋白6(Gas6)对骨折患者感染的诊断效果。方法 以2019年1月-2021年6月河南省驻马店市中心医院收治的进行骨折内固定手术治疗的188例患者为研究对象,依据患者是否发生术后感染分为感染组45例和非感染组143例,分析感染患者感染病原菌分布,单因素及多因素Logistic回归分析骨折患者术后感染影响因素,受试者工作特征(ROC)曲线分析Flt3L和Gas6对骨折患者术后感染的诊断效果。结果 45例术后感染患者共检出69株病原菌,其中革兰阳性菌23株(33.33%),主要为金黄色葡萄球菌,革兰阴性菌43株(62.32%),主要为铜绿假单胞菌,真菌3株(4.35%)。多因素Logistic分析结果显示,创口遗留死腔、合并糖尿病、手术时间≥3h是骨折患者术后感染的影响因素。ROC曲线分析结果显示,血清Flt3L、Gas6表达水平对骨折患者术后感染均有较佳的诊断效果,两者联合应用,特异度为0.902,敏感度为0.800。结论 创口遗留死腔、合并糖尿病、手术时间≥3h为骨折患者术后感染的影响因素,Flt3L、Gas6表达水平对骨折患者术后感染有较佳的诊断价值。OBJECTIVE To analyze the diagnostic effect of serum Flt3 ligand(Flt3 L) and growth arrest specific protein 6(Gas6) on infection in patients with fractures. METHODS A total of 188 patients admitted to Zhumadian Central Hospital in Henan province who underwent internal fracture fixation from Jan. 2019 to Jun. 2021 were selected as the research subjects, and were divided into 45 cases of infection group and 143 cases of control group according to whether the patients had postoperative infection. The distribution of pathogenic bacteria in infected patients were analyzed, univariate and multivariate Logistic regression was used to analyze the influencing factors of postoperative infection in patients with fractures, and receiver operating characteristic(ROC) curve was used to analyzed the diagnostic effect of Flt3 L and Gas6 on postoperative infection in patients with fractures. RESULTS A total of 69 pathogenic bacteria were detected in 45 patients with postoperative infection, of which 23 strains were Gram-positive bacteria(33.33%), mainly Staphylococcus aureus, 43 strains were Gram-negative bacteria(62.32%), mainly Pseudomonas aeruginosa, and 3 strains were fungi(4.35%). The results of multivariate Logistic analysis showed that the influencing factors of postoperative infection in fracture patients were dead cavity left in the wound, diabetes mellitus, and operation time ≥3 h. The results of ROC curve analysis results showed that serum Flt3 L and Gas6 had better diagnostic effects on postoperative infection in patients with fracture. The specificity was 0.902 and the sensitivity was 0.800 when the two were combined. CONCLUSION Dead space left in the wound, diabetes mellitus, and operation time ≥3 h were the influencing factors of postoperative infection in patients with fracture. The expression level of Flt3 L and Gas6 had better diagnostic value for postoperative infection in patients with fracture.

关 键 词：骨折 内固定手术 感染 FLT3配体 生长停滞特异性蛋白6 诊断价值 

分 类 号：R687[医药卫生—骨科学]