摘要
目的观察并比较３种骨科手术中Ｃ－反应蛋白（ＣＲＰ）与血沉（ＥＳＲ）的数值变化规律，并研究其在监测骨科术后感染中的临床意义。方法作者选择３种骨科手术：全髋成形术（ＴＨＡ）、膝关节单室成形术（ＵＫＡ）、腰椎间盘显微切除术（ＬＭＤ），对该３类手术后的ＣＲＰ及ＥＳＲ进行了连续测定。结果所有患者术后的ＣＲＰ均升高，ＴＨＡ组术后第３天达到峰值（１２０±３６）ｍｇ·Ｌ１，ＵＫＡ（１４３±４１）ｍｇ·Ｌ１及ＬＭＤ组（４６±２７）ｍｇ·Ｌ１术后第２天达到峰值。术后２１ｄ内ＣＲＰ通常降至正常，未发现ＣＲＰ与麻醉方式、出血量、输血、手术时间、投药、年龄及性别有相关性。ＥＳＲ大约在术后第５天升至峰值，继之出现缓慢，不规则下降，有时术后４２ｄ仍高于正常。结论在监测术后感染方面，ＣＲＰ优于ＥＳＲ。一旦术后感染发生，ＣＲＰ会在迅速下降过程中出现再次升高或持续升高。
Objective To
observe and compare the changing regularity of the levels of C-reactive protein (CRP)and
erythrocyte sedimentation rate (ESR) in three types of orthopedic operations,and to study their
clinic significance in monitoring orthopedic postoperative infection.Method The levels of CRP
and ESR were determined by serial measurements after three types of selected orthopedic
surgery.The type of operations chosen for this study were total hip arthroplasty
(THA),unicompartmental after knee arthroplasty (UKA) and lumber microdiskectomy
(LMD).Results In all patients,CRP levels increased after surgery,reaching peak levels on the
third day after hip arthroplasties(120±36)mg/L and on the second day knee arthroplasties (143
±41)mg/L and lumber microdiskectomy (46±27)mg/L.CRP levels usually dropped to normal
within 21 days after surgery.No correlation was found between CRP response and the type of
anesthesia,amount of bleeding,transfusion,operation time, administered drugs,age or
gender.ESR increased to peak levels about five days after surgery,followed by a slow and
irregular decrease,still 42 days after operation ESR sometimes remained elevated.Conclusion
The level of CRP must be considered a better diagnostic aid for the early detection of
postoperative infections than ESR. It can be assumed that the rapid decline in CRP after
orthopedic surgery will be interrupted by a second rise or by a persisting elevated level if
infectious complications occur.
出处
《铁道医学》
1999年第2期74-76,共3页
Railway Medical Journal
关键词
C-反应蛋白
术后感染
骨科手术
C-reactive protein postoperative infection
orthpedic operations
