全子宫切除术后医院感染患者凝血指标和炎症指标水平  

Levels of coagulation and inflammatory indexes in patients with nosocomial infections after total hysterectomy

作　　者：赵芬 杜易 崔洪银 钟欢欣 尤丽芳 黄嫦嫦 ZHAO Fen;DU Yi;CUI Hongyin;ZHONG Huanxin;YOU Lifang;HUANG Changchang(Linping District First People's Hospital,Hangzhou,Zhejiang 3ll1o0,China)

机构地区：[1]杭州市临平区第一人民医院妇产科,浙江杭州311100

出　　处：《中华医院感染学杂志》2025年第3期395-399,共5页Chinese Journal of Nosocomiology

基　　金：杭州市科技计划基金资助项目(20220919Y110)。

摘　　要：目的探讨全子宫切除术后医院感染凝血指标和炎症指标水平,为术后感染预防提供参考。方法选取2020年7月—2023年10月杭州市临平区第一人民医院收治的142例腹腔镜全子宫切除术患者,根据患者术后7 d医院感染情况分为感染组15例与未感染组127例,比较两组手术前后外周血凝血指标[凝血酶时间(TT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、活化部分凝血活酶时间(APTT)]、炎症指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)]水平。结果两组术后1 d凝血功能指标APTT、PT、TT时间较术前缩短;FIB水平较术前升高,且感染组高于未感染组(P<0.05);两组术后血清炎性因子IL-6、TNF-α、PCT、hs-CRP水平较术前升高,且感染组高于未感染组(P<0.05);与术后1 d比较,感染组术后3、7 d凝血功能指标APTT、PT、TT时间延长,FIB水平降低,未感染组术后3、7 d时APTT、PT、TT时间缩短,FIB水平升高,且感染组术后3、7 d时APTT、PT、TT时间长于未感染组,FIB水平低于未感染组(P<0.05);与术后1 d比较,感染组术后3、7 d血清炎性因子IL-6、TNF-α、PCT、hs-CRP水平升高,未感染组血清IL-6、TNF-α、PCT、hs-CRP水平降低,且感染组术后3、7 d时血清IL-6、TNF-α、PCT、hs-CRP水平高于未感染组(P<0.05)。结论全子宫切除术后医院感染风险较高,感染可导致机体凝血功能紊乱,炎性反应加重。OBJECTIVE To explore levels of coagulation and inflammatory indexes in nosocomial infections after total hysterectomy,and to provide reference for the prevention of postoperative infections.METHODS A total of 142 patients undergoing laparoscopic total hysterectomy in Linping District First People's Hospital,Hangzhou between Jul.2020 and Oct.2023 were selected and were divided into an infection group of 15 cases and a non-infection group of 127 cases according to the presence or absence of nosocomial infection within 7d after surgery.The peripheral blood coagulation indexes[thrombin time(TT),prothrombin time(PT),fibrinogen(FIB)and activated partial thromboplastin time(APTT)]and inflammatory indexes[tumor necrosis factorα(TNF-α),interleukin-6(IL-6),hypersensitive C-reactive protein(hs-CRP)and procalcitonin(PCT)]in the two groups were compared before and after surgery.RESULTS The coagulation function indexes APTT,PT and TT time of the two groups were shorter after the surgery for 1 day than before the surgery,and the FIB level was higher after the surgery for 1 days than before the surgery,and the FIB level of the infection group was higher than that of the no infection group(P<0.05).After surgery,levels of serum IL-6,TNF-α,PCT and hs-CRP were increased in both groups,which were higher in the infection group than those in the non-infection group(P<0.05).Compared with 1 d after surgery,the coagulation function indexes APTT,PT and TT were prolonged and FIB levels was decreased at 3 d and 7 d after surgery in the infection group,and APTT,PT and TT time was shortened,and FIB levels was increased in the non-infection group.At 3 d and 7 d after surgery,APTT,PT and TT in the infection group were longer than those in the non-infection group,and FIB was lower than that in the non-infection group(P<0.05).Compared with those at 1 d after surgery,levels of serum IL-6,TNF-α,PCT and hs-CRP were increased in the infection group at 3 d and 7 d after surgery,which were decreased in the non-infection group.At 3 d and 7 d after su

关 键 词：全子宫切除术 医院感染 病原菌特征 凝血功能 炎性因子 

分 类 号：R619.3[医药卫生—外科学]