经皮椎体成形术治疗脊柱转移性肿瘤椎体压缩性骨折术后早期切口感染的免疫指标变化及护理对策

Changes in immune indexes in early wound infection after percutaneous vertebroplasty for spine metastases associated vertebral compression fracture and nursing strategies

目的探讨经皮椎体成形术治疗脊柱转移性肿瘤椎体压缩性骨折术后早期切口感染的免疫指标变化及护理对策。方法选取2017年1月至2019年1月间延安大学附属医院收治的38例脊柱转移性肿瘤椎体压缩性骨折且行经皮椎体成形术后早期切口感染患者为感染组,选取同期40例未感染患者为未感染组,另筛选同期40例体检健康者为对照组,比较三组受试者免疫指标情况并探讨避免切口感染的护理对策。结果感染组患者免疫粘附促进因子(FEER)、协同肿瘤红细胞花环率(ATER)、直向肿瘤红细胞免疫花环率(DTER)和红细胞C3b受体花环率(C3bR)指标均低于非感染组和对照组,差异均有统计学意义(均P<0.05)。感染组患者白细胞介素(IL-7)、IL-9、IL-18和IL-19水平均高于未感染组和对照组,差异均有统计学意义(均P<0.05)。感染组患者一氧化碳(NO)、干扰素-γ(IFN-γ)和肿瘤坏死因子-α(TNF-α)水平均高于非感染组和对照组,差异均有统计学意义(均P<0.05)。结论经皮椎体成形术治疗脊柱转移性肿瘤椎体压缩性骨折表现出良好的临床疗效,检测红细胞免疫指标及促炎因子水平,能有效监测早期切口感染形成,以便采取针对性护理干预,纠正术后感染问题。

Objective To investigate the changes in immune indexes in early wound infection after percutaneous vertebroplasty for spine metastases associated vertebral compression fracture and nursing strategies.Methods Thirty-eight patients with spine metastases associated vertebral compression fracture who underwent percutaneous vertebroplasty and had wound infection at Yan’an University Affiliated Hospital from January 2017 to January 2019 were enrolled in a infection group.Forty patients with wound infection who underwent the same surgery at the hospital were included in a non-infection group.Another 40 healthy people who underwent physical examination in the hospital were selected as a control group.The immune indexes of the three groups were compared,and the nursing strategies to avoid wound infection were discussed.Results The erythrocyte rosette forming enhancing rate(RFER),associate tumor erythrogte rosette rate(ATER),direct tumor erythrocyte rosette rate(DTER)and red blood cell c3 b receptor rosette rate(RBC-C3 b RR)were lower in the infection group than in the non-infection group(all P<0.05).Levels of IL-7,IL-9,IL-18 and IL-19 were higher in the infection group than in the non-infection group(all P<0.05).Levels of NO,interferon-γ(IFN-γ)and tumor necrosis factor-α(TNFα)(all P<0.05).Conclusion Percutaneous vertebroplasty good clinical efficacy for spine metastases associated vertebral compression fracture.However,the wound infection is still unavoidable.Detection of red blood cell immune index and proinflammatory factor levels can effectively monitor the formation of early wound infections.Targeted care interventions should be taken to correct postoperative infection issues.