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| Expression and Significance of CRP, PCT and ESR in Patients with Incision Infection after Posterior Pedicle System Internal Fixation |
| LI Da-peng, LI Zhong-qiang |
| Department of Pelvic ,acetabulaceae Shenyang orthopaedic hospital , liaoning,shenyang 110044 |
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Abstract 【Objective】To investigate the expression and significance of C-reactive protein (CRP), procalcitonin (PCT) and erythrocyte sedimentation rate (ESR) in the serum of patients with incision infection after posterior pedicle system internal fixation.【Methods】From September 2016 to April 2018, 42 patients with incision infection after posterior pedicle system internal fixation were selected as the observation group (17 cases with superficial infection and 25 cases with deep infection), and 78 patients without infection after posterior pedicle system internal fixation were selected as the control group. The serum levels of CRP, PCT and ESR were compared before and 1,3,5,7 days after operation, and the correlation between them and infection was analyzed.【Results】There was no significant difference in the levels of CRP, PCT and ESR between the two groups (P>0.05); on the 1st, 3rd, 5th and 7th day after operation, the levels of CRP, PCT and ESR in the observation group were significantly higher than those in the same group before surgery and those of the control group at the same time (P<0.05). There was no significant difference in the levels of serum CRP, PCT and ESR between patients with Asabu infection and those with deep infection before and 1 d after operation (P>0.05). The levels of serum CRP, PCT and ESR in patients with deep infection were significantly higher than those in patients with shallow infection at 3, 5 and 7 d after operation (P<0.05).Pearson correlation analysis showed that serum CRP, PCT and ESR levels were positively correlated with leukocyte count in patients with incision infection after posterior pedicle system internal fixation. In the observation group, 67 strains of pathogenic bacteria were isolated from 42 infected patients, of which 44 were Gram-positive bacteria (65.67%), 19 were Gram-negative bacteria (28.36%) and 4 were fungi (5.97%).【Conclusion】The levels of CRP, PCT and ESR in patients with incision infection after posterior pedicle system internal fixation are closely related to the infection, and the main infection is Gram-positive bacteria.
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Received: 25 June 2019
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[1] 曹杰,申才良,于海洋,等.经皮椎弓根钉棒微创内固定系统结合伤椎植骨治疗胸腰椎骨折的临床效果[J].中国现代医学杂志,2018,28(22):74-79.
[2] 刘建宏,叶秀珠,邓红军,等.骨折内固定术后感染的临床特点及综合抗感染分析[J].中华医院感染学杂志,2017,27(24):5634-5637.
[3] Xu Z, Wang X, Wu P,et al. Surgical treatment for mono-segmental lumbar tuberculosis by single-stage posterior debridement, compact bone grafting and posterior single-segment fixation [J].Injury,2015, 46(7): 1311-1316.
[4] 林利兴,刘良乐,何少奇,等.血清生物学指标在脊柱内固定融合术后感染患者中的诊断价值[J].中华医院感染学杂志,2017,27(15):3522-3524.
[5] Meena UK, Bansal MC, Behera P, et al. Evaluation of functional outcome of pilon fractures managed with limited internal fixation and external fixation: A prospective clinical study [J].J Clin Orthop Trauma,2017,8(2): S16-S20.
[6] Yeoh D, Moffatt T, Karmani S. Good outcomes of percutaneous fixation of spinal fractures in ankylosing spinal disorders [J].Injury,2014,45(10): 1534-1538.
[7] 马文鑫,王骞,王自立,等.脊柱内固定术后感染的治疗[J].中国矫形外科杂志,2016,24(15):1357-1362.
[8] Lee YK, Yoon BH, Hwang JS, et al. Risk factors of fixation failure in basicervical femoral neck fracture: Which device is optimal for fixation [J]?Injury,2018,49(3): 691-696.
[9] 张宏其,谢江,邓盎,等.单纯后路病灶清除椎间植骨内固定治疗成人非特异性腰椎间隙感染[J].中国矫形外科杂志,2018,26(13):1165-1169.
[10] 陈磊.后路微创小切口减压联合经皮椎弓根螺钉复位内固定术与传统开放手术治疗伴神经功能损伤胸腰椎骨折的疗效[J].中国老年学杂志,2018,38(19):4672-4675.
[11] Giorgi H, Blondel B, Adetchessi T, et al. Early percutaneous fixation of spinal thoracolumbar fractures in polytrauma patients [J].Orthop Traumatol Surg Res,2014, 100(5): 449-454.
[12] Proietti L, Scaramuzzo L, Schirò GR, et al. Posterior percutaneous reduction and fixation of thoraco-lumbar burst fractures [J].Orthop Traumatol Surg Res,2014, 100(5): 455-460.
[13] 王会含,王永堂,卢良杰,等.CRP、PCT、ESR及WBC监测在腰椎后路内固定术后早期感染的临床价值分析[J].中华医院感染学杂志,2016,26(22):5175-5178.
[14] 赵正据,罗菊英,向一鸣.中老年患者脊柱内固定术前后C反应蛋白、红细胞沉降率的动态变化及其意义[J].中国老年学杂志,2014,34(4):1110-1111.
[15] Zhang T, Hu J, Wu J, et al. One-stage posterior debridement and fusion combined with irrigation and drainage for the treatment of postoperative lumbar spondylodiscitis[J].Acta Orthop Traumatol Turc,2018, 52(4): 277-282.
[16] 桑朝辉,任海龙,孟湛东,等.后路腰椎融合内固定术后感染的危险因素分析[J].南方医科大学学报,2018,38(8):969-974.
[17] 王宇强,贾永森,翟磊,等.骨折内固定术后感染病原菌分布及感染对患者预后的影响[J].中华医院感染学杂志,2017,27(13):3025-3027. |
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2020, Vol. 37 
