剖宫产术后肺部感染血清炎症因子与影响因素分析

Serum inflammatory factors for pulmonary infection after cesarean section and influencing factors

目的 探讨剖宫产妇女术后肺部感染血清降钙素原(PCT)与白细胞介素(IL-6)及影响因素。方法 选择2017年1-12月于医院接受治疗的剖宫产妇女1 600例为研究对象,根据术后肺部感染情况分为感染组422例和未感染组1 178例。观察两组产妇术前及术后1 d、3 d的血清PCT与IL-6的表达水平。将产妇的年龄、体质量、入院时间、家族感染史、妊娠次数、手术用时、辅助呼吸、术后抗菌药物的使用情况进行分析,归纳剖宫产产妇术后肺部感染的影响因素。结果 两组产妇术前的血清PCT与IL-6差异无统计学意义;两组产妇术后1 d、3 d的血清PCT与IL-6的水平表达高于术前(P<0.05),且感染组产妇PCT与IL-6为(32.10±3.44)μg/ml、(75.61±8.94)μg/ml与(19.25±5.22)mg/L、(26.52±6.88)mg/L高于未感染组(P<0.05),且随着时间延长水平也升高(P<0.05)。住院时间、辅助呼吸、抗菌药物使用是剖宫产妇女术后肺部感染的影响因素(P<0.05)。结论 血清PCT与IL-6可作为剖宫产术后产妇肺部感染的有效诊断指标,对于产妇术后肺部感染的影响因素进行分析,及时采取应对措施,当血清PCT与IL-6水平指标异常时应及时进行治疗,以避免感染进一步发展。

OBJECTIVE To investigate procalcitonin(PCT)and interleukin(IL-6)and influencing factors of postoperative pulmonary infection in women undergoing cesarean section.METHODS 1600 women undergoing cesarean section in the hospital from Jan.to Dec.in 2017 were chosen,and divided into infected group(422 cases)and uninfected group(1178 cases).The levels of serum PCT and IL-6 were measured before operation and 1 day and 3 days after operation.The maternal age,body weight,hospitalization time,family infection history,pregnancy frequency,time of surgery,assisted breathing,and postoperative antibiotic use were analyzed to summarize the influencing factors of postoperative pulmonary infection in cesarean section women.RESULTS There was no significant difference in preoperative serum PCT and IL-6 between the infected and uninfected women.The levels of serum PCT and IL-6 on day 1 and day 3 after operation in the two groups were significantly higher than those before operation(P<0.05).The PCT and IL-6 levels of infected women were(32.10±3.44)μg/ml,(75.61±8.94)μg/ml and(19.25±5.22)mg/L,(26.52±6.88)mg/L),respectively,significantly higher than those of the uninfected group(P<0.05),and the levels increased with time(P<0.05).Long hospital stay,assisted breathing,and use of antibiotics were the influencing factors of postoperative pulmonary infection in cesarean section women(P<0.05).CONCLUSION PCT and IL-6 in serum can be used as effective diagnostic indicators for maternal lung infection after cesarean section.The factors affecting postoperative pulmonary infection in pregnant women should be analyzed,and timely response measures should be taken when the serum PCT and IL-6 levels are abnormal.Treatment should be taken promptly to avoid further infection.