摘要
目的 探究头颈恶性肿瘤术后切口感染影响因素及C-反应蛋白(CRP)与可溶性髓系细胞触发受体-1(sTREM-1)和白细胞介素-6(IL-6)水平。方法 回顾性分析2017年6月-2020年10月河北医科大学第四医院收治的114例行头颈恶性肿瘤根治术术后负压引流患者临床资料,分析患者切口感染的发生情况,归纳头颈恶性肿瘤术后切口感染的影响因素,并应用受试者工作特征曲线(ROC)判断单一或多个指标对切口感染的预测价值。结果 114例患者存在35例感染患者,感染发生率为30.70%;手术时间、术后白蛋白水平、合并糖尿病、预防性抗菌药物使用时间是头颈恶性肿瘤术后切口感染的影响因素(P<0.05)。3 d时点术后引流液的CRP、sTREM-1和IL-6三指标均具有较高的诊断价值,曲线下面积(AUC)(95%CI)分别为0.782(0.624~0.980)、0.718(0.546~0.945)和0.753(0.584~0.970),联合应用价值更高,AUC(95%CI)为0.844(0.743~0.959)。结论 术后引流液CRP、sTREM-1、IL-6及其联合应用对术后切口感染具有较高的诊断价值。
OBJECTIVE To explore the influencing factors for postoperative incision infection in the patients with head and neck malignant tumors and observe the levels of C-reactive protein(CRP), soluble triggering receptor expressed on myeloid cells(sTREM-1) and interleukin-6(IL-6). METHODS The clinical data of 114 patients with negative pressure drainage after radical surgery of head and neck malignancy treated in the Fourth Hospital of Hebei Medical University from Jun 2017 to Oct 2020 were prospectively analyzed. The occurrence of incision infection was analyzed, and the influencing factors of postoperative incision infection of head and neck malignancy were summarized. The Receiver Operating Characteristic Curve(ROC) was used to determine the predictive value of single or multiple indicators for incision infection. RESULTS Among 114 patients, 35 cases were infected, and the infection rate was 30.70%. Operation time, postoperative serum protein, combined diabetes and duration of antimicrobial prophylaxis were the influential factors of postoperative incision infection of patients with head and neck malignancies(P<0.05). The three indicators of CRP, sTREM-1 and IL-6 in postoperative drainage fluid at 3 d time point were of high diagnostic value, and the AUC(95%CI) were 0.782(0.624-0.980), 0.718(0.566-0.945) and 0.753(0.584-0.970), respectively. The combined application value was higher, and the AUC(95%CI) was 0.844(0.743-0.959). CONCLUSION Postoperative drainage fluid CRP, sTREM-1, IL-6 and their combined application had high diagnostic value for postoperative incision infection.
作者
刘大响
王令焕
徐梅
王秀珍
高超
王翠荣
LIU Da-xiang;WANG Ling-huan;XU Mei;WANG Xiu-zhen;GAO Chao;WANG Cui-rong(Fourth Hospital of Hebei Medical University,Shijiazhuang,Hebei 050035,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第3期430-433,共4页
Chinese Journal of Nosocomiology
基金
河北省卫生厅医学科学研究基金资助项目(ZD20140393)。
