WBC、CRP及ESR在早期诊断脊柱后路术后感染的临床意义

Clinical Significance of WBC,CRP and ESR in Early Diagnosis of Postoperative Infection in Patients with Spinal Posterior Approach

目的了解在同等手术创伤影响情况下行脊柱后路术后感染患者及非感染患者血清白细胞(WBC)计数、C-反应蛋白(CRP)及红细胞沉降率(ESR)的变化规律,比较上述指标在早期诊断脊柱术后感染的临床意义。方法回顾分析2012年1月—2015年1月行后路单节段脊柱椎间融合椎弓根螺钉内固定手术患者,根据术后有无发生切口内深部感染分为A(非感染)组及B(感染)组,收集术前、术后3d、术后6d外周血WBC、CRP、ESR检测结果,根据分组进行动态比较及统计学分析。结果各组术后WBC、CRP、ESR水平较术前增高(P<0.05),术后感染组WBC、CRP、ESR水平明显高于非感染组(P<0.05),CRP变化较WBC、ESR更加迅速敏感。结论脊柱术后患者WBC、CRP、ESR均有不同程度增高,术后并发感染的患者较非感染患者上述指标升高更明显,其中CRP的变化更加迅速敏感。在脊柱术后感染的早期诊断中,CRP的参考价值最高,ESR及WBC参考价值较低。

Objective To understand the changes of serum white blood cell （WBC） count,C-reactive protein （CRP） and erythrocyte sedimentation rate （ESR） in patients with the same surgical trauma, and to compare the clinical significance of these indexes in early diagnosis of spinal surgery.Methods A retrospective was done with 61 patients who underwent mono segmental spinal fusion with pedicle screw fixation.According to the postoperative incidence incision deep infection, patients were divided into group A （non-infection） and group B （infection group）.BIood was drawn before breakfast prior to the operation,and 3 days,6 days after the operation.WBC,CRP, ESR were measured and according to the grouping were dynamic com- pared and statistical analyzed.Results The levels of ESR, CRP and WBC were significantly, higher after operation（P〈0.05）, and the difference was significant.WBC, CRP and ESR levels were compared,and the infection group was higher than the non infected group（P〈0.05）, and the change of CRP was more rapid and sensitive than that of ESR and WBC.Conclusion CRP, ESR and WBC were increased in patients with spinal surgery, and the patients were significantly higher than those with non infected patients.The changes of CRP were more sensitive than WBC and ESR.In the early diagnosis of infection after spinal operation,the reference value of CRP was the highest,and the reference value of ESR and WBC was lower.