胸腰椎骨折术后切口感染患者血清炎症因子水平变化及临床意义

Changes and Clinical Significance of Serum Inflammatory Factors in Patients with Incisional Infection after Thoracolumbar Fracture Surgery

目的探讨胸腰椎骨折术后切口感染的血清炎症因子水平变化及临床意义。方法纳入手术治疗的255例胸腰椎骨折患者,依据其切口感染情况,设为感染组(30例)与未感染组(225例),同时选择30例正常体检者作为正常组。抽取感染组感染后1、3 d的空腹静脉血,观察其血清炎症因子水平,并与非感染组患者进行比较;将感染组患者分为深部感染(12例)与浅部感染(18例),比较其血清炎症因子水平变化情况。结果感染组患者感染1、3 d的血清TNF-α、hs-CRP、IL-6、IL-8水平显著高于非感染组及对照组,且非感染组显著高于对照组(P<0.05);非感染组3 d的所有炎性因子水平均较1 d显著降低;感染组感染3 d的hs-CRP水平较感染1 d显著降低(P<0.05),TNF-α、IL-6、IL-8水平差异无统计学意义(P>0.05);深部感染患者1、3 d的血清TNF-α、hs-CRP、IL-6、IL-8水平显著高于浅部感染者(P<0.05)。结论胸腰椎骨折患者术后切口感染发生率较高,且血清炎症因子水平亦显著升高,深部切口感染者升高更为明显;血清炎症因子水平变化可用于切口感染的早期监测。

Objective To investigate the changes of serum inflammatory factors in postoperativeincision infection of thoracolumbar fractures and its clinical significance. Methods 255 cases ofthoracolumbar fractures were included in the study. According to their incision infection, they weredivided into infection group （30 cases） and non -infection group （225 cases）. The levels of seruminflammatory factors were observed and compared with those of non-infectious group. The patients weredivided into deep infection group （12 cases） and superficial infection group （18 cases）, and the changesof serum inflammatory factors were compared. Results The levels of serum TNF-a, hs-CRP, IL-6 andIL-8 in infected group were significantly higher than those in non-infected group and control group at 1and 3 days after infection, and those in non -infected group were significantly higher than those incontrol group （P〈0.05）. The levels of all inflammatory factors in 3 days of non infection group weresignificantly lower than those of 1 day; The levels of hs-CRP at 3 days of infection were significantlylower than those at 1 day of infection （P〈0.05）. There was no significant difference in the levels of TNF-a, IL-6 and IL-8 between the two groups （P〉0.05）; The levels of serum TNF-a, hs-CRP, IL-6 and IL-8in patients with deep infection were significantly higher than those in patients with superficial infectionat 1 and 3 days （P〈0.05）. Conclusion Patients with thoracolumbar fractures have a higher incidence ofincision infection, and the serum levels of inflammatory factors are significantly increased, especially inpatients with deep incision infection.