摘要
目的探讨普外科患者术后切口感染(SSI)的致病微生物分布特征及血清乳酸脱氢酶(LDH)、白细胞介素(IL)-6对感染的预测价值。方法选取2021年1月至2023年6月在该院普外科进行手术的患者100例为研究对象。根据术后感染发生情况分为感染组(28例)和非感染组(72例)。收集患者的基本资料,包括年龄、性别、手术类型、手术时间、切口类型、切口愈合情况等。在无菌条件下,对患者切口分泌物进行细菌培养和病原菌鉴定。检测患者术后第1天和第3天的血清LDH、IL-6水平,并比较感染组和非感染组LDH、IL-6水平差异。采用Pearson相关分析血清LDH水平与IL-6的相关性,采用多因素Logistic回归分析SSI的影响因素,绘制受试者工作特征(ROC)曲线分析血清LDH、IL-6水平对SSI的诊断效能。结果100例患者中,有28例发生了SSI,感染率为28%。感染组与非感染组年龄、手术时间、切口类型比较,差异有统计学意义(P<0.05)。细菌培养结果显示,感染组患者共分离出35株细菌,其中革兰阳性菌占54.29%,革兰阴性菌占45.71%,以金黄色葡萄球菌(14株)、铜绿假单胞菌(7株)、大肠埃希菌(5株)为主。感染组术后第1、3天血清LDH、IL-6水平均高于非感染组(P<0.05),感染组血清LDH水平与IL-6呈正相关(r=0.512,P<0.001)。多因素Logistic回归分析显示,年龄、手术时间、切口类型及术后第3天血清LDH、IL-6水平是影响SSI的独立危险因素(P<0.05)。ROC曲线分析显示,血清LDH、IL-6水平对SSI的诊断效能较高,其曲线下面积分别为0.89、0.88,最佳临界值分别为210 U/L、15 pg/mL,灵敏度分别为82.14%、85.71%,特异度分别为78.57%、80.36%。结论普外科患者SSI的致病微生物以金黄色葡萄球菌和铜绿假单胞菌为主,血清LDH、IL-6水平可作为SSI的预测指标,对感染的早期诊断和治疗具有重要意义。
Objective To explore the general surgery patients with postoperative incision infection(SSI)of pathogenic microorganism distribution characteristics and serum lactate dehydrogenase(LDH),interleukin(IL)-6 to the predictive value of infection.Methods A total of 100 patients who underwent surgery in the General Surgery Department of the hospital from January 2021 to June 2023 were selected as the research objects.According to the occurrence of postoperative infection,the patients were divided into infection group(28 cases)and non-infection group(72 cases).The basic data of the patients were collected,including age,gender,operation type,operation time,incision type,and incision healing.Bacterial culture and pathogen identification were performed on the incision secretion of patients under sterile conditions.At the same time,the serum LDH and IL-6 levels of the patients on the first and third day after operation were detected,and the differences of LDH and IL-6 levels between the infection group and the non-infection group were compared.Pearson correlation analysis was used to analyze the correlation between serum LDH level and IL-6.Multivariate Logistic regression analysis was used to analyze the influencing factors of SSI.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of serum LDH and IL-6 levels for SSI.Results Among the 100 patients,28 patients developed SSI,and the infection rate was 28%.There were significant differences in age,operation time,and incision type between the infection group and the non-infection group(P<0.05).The results of bacterial culture showed that a total of 35 strains of bacteria were isolated from the patients in the infection group,of which Gram-positive bacteria accounted for 54.29%and Gram-negative bacteria accounted for 45.71%,mainly Staphylococcus aureus(14 strains),Pseudomonas aeruginosa(7 strains),and Escherichia coli(5 strains).The serum levels of LDH and IL-6 in the infection group were higher than those in the non-infection group on postoperative days 1 and 3(P<0.05).The serum level of LDH in the infection group was positively correlated with IL-6(r=0.512,P<0.001).Multivariate Logistic regression analysis showed that age,operation time,type of incision,and serum LDH and IL-6 levels on postoperative day 3 were independent risk factors for SSI(P<0.05).ROC curve analysis showed that serum LDH and IL-6 levels had a high diagnostic efficacy for SSI,with an area under the curve of 0.89 and 0.88,the best cut-off values of 210 U/L and 15 pg/mL,the sensitivity of 82.14%and 85.71%,and the specificity of 78.57%and 80.36%,respectively.Conclusion Staphylococcus aureus and Pseudomonas aeruginosa are the main pathogenic microorganisms of SSI in general surgical patients.Serum LDH and IL-6 levels can be used as predictors of SSI,which is of great significance for early diagnosis and treatment of infection.
作者
邓强
张雷
何流
苏惠婷
许文娟
DENG Qiang;ZHANG Lei;HE Liu;SU Huiting;XU Wenjuan(Department of Experimental Medicine,Guang′an People′s Hospital,Guang′an,Sichuan 638000,China)
出处
《国际检验医学杂志》
CAS
2024年第12期1506-1510,共5页
International Journal of Laboratory Medicine
关键词
普外科
术后切口感染
乳酸脱氢酶
致病微生物
白细胞介素-6
general surgery
postoperative incision infection
lactate dehydrogenase
pathogenic microorganism
interleukin-6
