降钙素原在骨折手术部位感染中的诊断价值研究(1)
[摘要]目的 探討降钙素原(PCT)在骨折手术部位感染中的诊断价值。方法 将2013年10月～2016年3月我院收治的156例开放性骨折手术治疗患者，依据术后是否并发感染分为感染组62例和非感染组94例，采集静脉血于术后第1、3、5、7天检测PCT、C反应蛋白(CRP)及白细胞(WBC)各指标变化，分析其在骨折手术部位感染中的诊断应用价值。结果 与术前比较，术后感染组PCT、CRP及WBC水平均出现不同程度的升高，且两组PCT、CRP及WBC水平均呈现先升高后降低的趋势；术后第1、3天非感染组PCT、CRP及WBC水平较术前差异有统计学意义(P<0.05)。术后第1、3、5、7天感染组PCT、CRP及WBC水平显著高于非感染组，差异有统计学意义(P<0.05)，感染组PCT水平在术后第5天达到最高水平。PCT水平对骨折术后感染的诊断特异度、准确度和阴性预测值均优于CRP及WBC。结论 在骨折手术部位感染患者中PCT显著升高，作为诊断骨折手术部位感染的指标具有显著的特异度，且准确度高，可作为临床诊断标准之一，为相关病症的诊断和治疗提供科学依据，值得临床推广应用。
[关键词]降钙素原；骨折；手术部位；感染；C反应蛋白
[中图分类号] R687.3；R446.1 [文献标识码] A [文章编号] 1674-4721(2016)11(a)-0053-03
[Abstract]Objective To investigate the diagnostic value of calcitonin (PCT) in the infection of the surgical site of fracture.Methods From October 2013 to March 2016，156 patients with open fracture surgery treated in our hospital were divided into 62 cases of infection group and 94 cases of non infection group according to whether the postoperative infection.The changes of PCT，C reactive protein (CRP) and white blood cell (WBC) were detected on the first，third，5th，7th day after operation，and the diagnosis value of the infection in the surgical site of fracture was analyzed.Results Compared with preoperative，PCT，CRP and WBC levels were elevated in different degrees in the infection group after operation，PCT，CRP and WBC levels in two groups were increased at first and then decreased；there was statistical difference in PCT，CRP and WBC levels on the first and third day after operation compared with preoperative in the non infection group (P<0.05).The levels of PCT，CRP and WBC on the first，third，5th，7th day after operation in the infection group was significantly higher than that in the non infected group，and the difference was statistically significant (P<0.05).The level of PCT in infection group reached the highest level on the 5th day after operation.The diagnostic specificity，accuracy and negative predictive value of PCT was better than that of CRP and WBC in the diagnosis of infection after fracture operation.Conclusion PCT in patients with surgical site infection of fracture increases significantly，has remarkable specificity，and high accuracy as the diagnosis index of surgical site infection of fracture，can be used as one of the criteria of clinical diagnosis，provide scientific basis for diagnosis and treatment of related diseases，which is worthy of clinical popularization and application.
[Key words]Calcitonin；Fracture；Surgical site；Infection；C reactive protein (黄聿峰 魏林文)
[关键词]降钙素原；骨折；手术部位；感染；C反应蛋白
[中图分类号] R687.3；R446.1 [文献标识码] A [文章编号] 1674-4721(2016)11(a)-0053-03
[Abstract]Objective To investigate the diagnostic value of calcitonin (PCT) in the infection of the surgical site of fracture.Methods From October 2013 to March 2016，156 patients with open fracture surgery treated in our hospital were divided into 62 cases of infection group and 94 cases of non infection group according to whether the postoperative infection.The changes of PCT，C reactive protein (CRP) and white blood cell (WBC) were detected on the first，third，5th，7th day after operation，and the diagnosis value of the infection in the surgical site of fracture was analyzed.Results Compared with preoperative，PCT，CRP and WBC levels were elevated in different degrees in the infection group after operation，PCT，CRP and WBC levels in two groups were increased at first and then decreased；there was statistical difference in PCT，CRP and WBC levels on the first and third day after operation compared with preoperative in the non infection group (P<0.05).The levels of PCT，CRP and WBC on the first，third，5th，7th day after operation in the infection group was significantly higher than that in the non infected group，and the difference was statistically significant (P<0.05).The level of PCT in infection group reached the highest level on the 5th day after operation.The diagnostic specificity，accuracy and negative predictive value of PCT was better than that of CRP and WBC in the diagnosis of infection after fracture operation.Conclusion PCT in patients with surgical site infection of fracture increases significantly，has remarkable specificity，and high accuracy as the diagnosis index of surgical site infection of fracture，can be used as one of the criteria of clinical diagnosis，provide scientific basis for diagnosis and treatment of related diseases，which is worthy of clinical popularization and application.
[Key words]Calcitonin；Fracture；Surgical site；Infection；C reactive protein (黄聿峰 魏林文)