| 宋 蕾,黄 海,李若静,高 亮,王培戈.急性阑尾炎患者术后切口感染的病原菌分析及NLR、PCT、CRP联合检测的预测价值研究[J].,2023,(17):3359-3364 |
| 急性阑尾炎患者术后切口感染的病原菌分析及NLR、PCT、CRP联合检测的预测价值研究 |
| Pathogenic Bacteria Analysis of Postoperative Incision Infection in Patients with Acute Appendicitis and the Predictive Value Study of Combined Detection of NLR, PCT and CRP |
| 投稿时间：2023-02-25 修订日期：2023-03-21 |
| DOI：10.13241/j.cnki.pmb.2023.17.031 |
| 中文关键词: 急性阑尾炎 切口感染 病原菌 NLR PCT CRP 预测价值 |
| 英文关键词: Acute appendicitis Incision infection Pathogenic bacteria NLR PCT CRP Predictive value |
| 基金项目:泰山学者特聘专家基金项目（2018092901） |
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| 中文摘要: |
| 摘要 目的：分析急性阑尾炎（AA）患者术后切口感染的病原菌并探讨中性粒细胞与淋巴细胞比值（NLR）、降钙素原（PCT）、C反应蛋白（CRP）联合检测的预测价值。方法：选取2020年1月～2022年9月青岛大学附属医院收治的379例接受腹腔镜或开腹手术的AA患者，根据是否发生术后切口感染分为感染组和非感染组，收集AA患者临床资料并检测NLR、PCT、CRP水平。分析术后切口感染AA患者病原菌分布情况，采用单因素和多因素Logistic回归分析AA患者术后切口感染的影响因素，采用受试者工作特征（ROC）曲线分析NLR、PCT、CRP对AA患者术后切口感染的预测价值。结果：379例AA患者术后切口感染发生率为12.40%（47/379），47例术后切口感染AA患者切口分泌物共检测出75株病原菌，革兰氏阳性菌和革兰氏阴性菌分别占比42.67%（32/75）、57.33%（43/75）。感染组NLR、PCT、CRP水平高于非感染组（P＜0.05）。多因素Logistic回归分析显示，年龄≥60岁、病程≥24 h、阑尾化脓或坏疽及穿孔、开腹手术、留置引流管和血清NLR、PCT、CRP升高为AA患者术后切口感染的独立危险因素，预防性应用抗菌药物为其独立保护因素（P＜0.05）。ROC曲线分析显示，NLR、PCT、CRP联合预测AA患者术后切口感染的曲线下面积大于NLR、PCT、CRP单独预测。结论：术后切口感染AA患者病原菌以革兰氏阴性菌为主，术前NLR、PCT、CRP水平升高与AA患者术后切口感染密切相关，三者联合预测AA患者术后切口感染的价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the pathogenic bacteria of postoperative incision infection in patients with acute appendicitis (AA) and to investigate the predictive value of the combined detection of neutrophil-to-lymphocyte ratio (NLR), procalcitonin (PCT) and C-reactive protein (CRP). Methods: 379 patients with AA who received laparoscopic or open surgery in Affiliated Hospital of Qingdao University from January 2020 to September 2022 were selected, and they were divided into infected group and non-infected group according to whether postoperative incision infection occurred. Clinical data of patients with AA were collected and NLR, PCT and CRP levels were detected. The distribution of pathogenic bacteria of postoperative incision infection in patients with AA was analyzed. The influencing factors of postoperative incision infection in patients with AA were analyzed by univariate and multivariate Logistic regression. The predictive value of NLR, PCT and CRP in postoperative incision infection in patients with AA was analyzed by receiver operating characteristic (ROC) curve. Results: The incidence of postoperative incision infection in 379 patients with AA was 12.40% (47/379), and 75 strains of pathogenic bacteria were detected in the incision secretions of postoperative incision infection in 47 patients with AA, with Gram-positive bacteria and Gram-negative bacteria accounting for 42.67% (32/75) and 57.33% (43/75), respectively. The levels of NLR, PCT and CRP in the infected group were higher than those in the non-infected group(P＜0.05). Multivariate Logistic regression analysis showed that age ≥60 years old, disease course ≥24 h, appendectomy purulent or gangrene and perforation, open surgery, indwelling drainage tube and increased serum NLR, PCT and CRP were independent risk factors for postoperative incision infection in patients with AA, and preventive use of antibacterial drugs was independent protective factor(P＜0.05). ROC curve analysis showed that the combined prediction of NLR, PCT and CRP for postoperative incision infection in patients with AA was larger than that of NLR, PCT and CRP alone. Conclusion: The pathogenic bacteria of postoperative incision infection in patients with AA are mainly Gram-negative bacteria. The increase of preoperative NLR, PCT and CRP levels are closely related to postoperative incision infection in patients with AA, and the combined value of the three is high in predicting postoperative incision infection in patients with AA. |
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