血清炎症水平对闭合性骨折术后出现感染的预测价值

Predictive Value of Serum Inflammation Level for Infection after Closed Fracture Surgery

目的探讨血清炎症水平对闭合性骨折术后出现感染预测价值。方法回顾性分析2018年9月到2019年3月于我院行闭合性骨折手术患者122例,以术后是否出现感染将其分为观察组(n=61)和对照组(n=61),对比两组术后C-反应蛋白(CRP)、动态红细胞沉降率(ESR)、血清降钙素原(PCT)、白细胞计数(WBC),多因素Logistic回归分析感染危险因素,ROC曲线分析比较CRP、ESR、PCT、WBC对闭合性骨折术后患者感染率的预测价值。结果观察组术后第3、5、7d血清CRP、ESR、PCT、WBC明显高于对照组,有统计学差异(P<0.05);术后第3d血清CRP、ESR、PCT、WBC与感染有明显相关性,有统计学差异(P<0.05);四项指标联合确诊闭合性骨折术后感染敏感性和特异性较单独确诊敏感性和特异性高,有统计学差异(P<0.05)。结论血清CRP、ESR、PCT、WBC直接反映闭合性骨折术后是否感染,且四项指标联合检测更准确。

Objective To investigate the predictive value of serum inflammation level for infection after closed fracture surgery.Methods The data of 120 patients who underwent closed fracture surgery in our hospital from September 2018 to March 2019 were retrospectively analyzed,patients were divided into two groups according to the presence or absence of the postoperative infection,namely,observation group and control group,each with 61 cases.Then various indexes were compared between groups,including c-reactive protein(CRP),dynamic erythrocyte sedimentation rate(ESR),serum procalcitonin(PCT),and white blood cell count(WBC).Their risk factors for infection by Pearson correlation analysis,Then the ROC curve analysis was used to compare the value of CRP,ESR,PCT and WBC in the prediction of inflammation after closed fracture surgery.Results CRP,ESR,PCT and WBC were significantly higher in the observation group than in the control group at postoperative 3,5 and 7 days(P<0.05).CRP,ESR,PCT and WBC were significantly correlated with infection on postoperative 3 d(P<0.05).The sensitivity and specificity of the combined detection of four indicators for the diagnosis of infection after closed fracture surgeries were high(P<0.05).Conclusion Serum CRP,ESR,PCT,WBC levels can directly reflect the infection after closed fracture,and the combined detection of four indicators has the highest accuracy.