血清淀粉样蛋白A、中性粒细胞/淋巴细胞比值、血小板/淋巴细胞比值与急性化脓性阑尾炎患儿术后切口感染的关系

Relationship between Serum Amyloid A,Neutrophil/Lymphocyte Ratio,Platelet/Lymphocyte Ratio and Postoperative Incision Infection in Children with Acute Suppurative Appendicitis

目的:探讨血清淀粉样蛋白A(SAA)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)与急性化脓性阑尾炎患儿术后切口感染的关系。方法:选择418例急性化脓性阑尾炎患儿,观察术后7 d内切口感染情况,根据术后感染情况分为感染组和未感染组。对比感染组和未感染组术前血清SAA、NLR、PLR。采用单因素和多因素Logistic回归模型分析术后切口感染的影响因素。绘制受试者工作特征(ROC)曲线评估术前血清SAA、NLR、PLR对急性化脓性阑尾炎患儿术后切口感染的预测价值。结果:418例急性化脓性阑尾炎患儿中,有54例出现术后切口感染,感染率为12.92%。感染组术前血清SAA、NLR、PLR高于未感染组(P<0.05)。术后切口感染与手术时间、手术方式有关(P<0.05);而与性别、年龄、切口长度、发病至手术的平均时间无关(P>0.05)。术前手术时间偏长、血清SAA升高、NLR升高、PLR升高、手术方式为开腹是术后切口感染的危险因素(P<0.05)。术前血清SAA、NLR、PLR联合检测预测术后切口感染的效能大于各指标单独预测。结论:术前血清SAA水平及NLR、PLR在急性化脓性阑尾炎术后切口感染患儿中升高,三指标联合检测对术后切口感染发生具有较高的预测效能,血清SAA、NLR、PLR、手术时间、手术方式是术后切口感染的影响因素。

Objective:To investigate the relationship between serum amyloid A(SAA),neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR)and postoperative incision infection in children with acute suppurative appendicitis.Methods:418 children with acute suppurative appendicitis were selected,and the incision infection was observed within 7 d after operation,patients were divided into infected group and uninfected group according to whether postoperative infection occurred.Preoperative serum SAA,NLR and PLR were compared between infected group and uninfected group.The influencing factors of postoperative incision infection were analyzed by univariate and multivariate Logistic regression models.The predictive value of preoperative serum SAA,NLR and PLR for postoperative incision infection were evaluated by receiver operating characteristic(ROC)curve.Results:418 children with acute suppurative appendicitis,54 had postoperative incision infection,with an infection rate of 12.92%.The preoperative serum SAA,NLR and PLR in infected group were higher than those in uninfected group(P<0.05).Postoperative incision infection was related to operation time and operation method(P<0.05).And not related to gender,age,incision length,and the average time from onset to surgery(P>0.05).Long preoperative operation time,elevated serum SAA,elevated NLR,elevated PLR,and operation method was laparotomy were risk factors for postoperative incision infection(P<0.05).The efficacy of combined detection of preoperative serum SAA,NLR and PLR in predicting postoperative incision infection was greater than that of each index alone.Conclusion:Preoperative serum SAA level,NLR and PLR are elevate in children with incision infection after acute suppurative appendicitis,the combine detection in three indicators has a high predictive efficiency for postoperative incision infection occurrence,serum SAA,NLR,PLR,operation time and operation method are the influencing factors of postoperative incision infection.