神经外科术后患者体温、WBC、CRP和PCT的术后变化规律研究

The change regulation of body temperature,WBC,CRP and PCT of patients after neurosurgical operation

目的探讨神经外科术后患者体温、白细胞(WBC)、C-反应蛋白(CRP)和降钙素原(PCT)的术后变化规律,探讨其临床适用性。方法将2010年5月至2014年9月接受治疗的90例神经外科术后患者作为病例资料,按照术后感染分为感染组46例和非感染组44例。检测所有患者术后第1天、第3天、第5天、第7天的平均体温、WBC、CRP和PCT水平,记录感染组患者WBC、CRP等指标单一检测以及联合检测的细菌感染阳性率,对结果进行分析。结果感染组患者在第3天、第5天、第7天的平均体温明显高于非感染组,第3天、第5天、第7天的平均WBC明显高于非感染组,第5天、第7天的平均CRP明显高于非感染组,第1天、第3天、第5天、第7天的平均血清PCT水平明显高于非感染组,差异均有统计学意义(P<0.05);在感染组中,PCT的阳性率明显高于体温、WBC和CRP(P<0.05),而联合检测的阳性率高于单一检测,差异有统计学意义(P<0.05)。结论 PCT水平的检测优于体温、WBC、CRP等指标,而联合检测WBC、CRP和PCT对判断神经外科术后感染有重要的意义,适合临床推广应用。

Objective To investigate the change regulation of body temperature,WBC,CRP and PCT of patients after neurosurgical operation,and to explore its clinical applicability. Methods Ninety patients after who received neurosurgical operation in our hospital from May 2010 to September 2014 were divided into infection group（ n = 46） and non-infection group（ n = 44）. The average temperature 1d,3d,5d,7d after operation,the levels of WBC,CRP and PCT were detected for both groups,the positive rates of bacterial infections by single index detection and combination detection in infection group were recorded,finally,the research results were analyzed and compared between two groups. Results The average body temperature and average WBC numbers on 3d,5d,7d in infection group were significantly higher than those in non-infection group,moreover,average CRP on 5d,7d in infection group was significantly higher than that in non-infection group,average PCT levels on 1d,3d,5d,7d in infection group were significantly higher than those in non-infection group（ P〈0. 05）. The positive rate of PCT＇ in infection group was significantly higher than body temperature,WBC,CRP,moreover,the positive rate of combination detection was significantly higher than that of single detection（ P〈0. 05）. Conclusion PCT level detection is superior to the detection of body temperature,WBC,CRP,moreover,combination detection of WBC,CRP,PCT has important significance in evaluating infection after neurosurgical operation,thus,it is worthy to be widely applied in clinic.