| 术前炎症反应指标对脊柱手术后切口感染的预测价值 |
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投稿时间：2024-03-15
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| 作者 | Author | 单位 | Address | E-Mail |
| 梁维 |
LIANG Wei |
濮阳市油田总医院骨科, 河南 濮阳 457001 |
Department of Orthopaedics, Puyang Oilfield General Hospital, Puyang 457001, Henan, China |
e3dnb1b@163.com |
| 卓瑞立 |
ZHUO Rui-li |
濮阳市油田总医院骨科, 河南 濮阳 457001 |
Department of Orthopaedics, Puyang Oilfield General Hospital, Puyang 457001, Henan, China |
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| 孙韶东 |
SUN Shao-dong |
濮阳市油田总医院骨科, 河南 濮阳 457001 |
Department of Orthopaedics, Puyang Oilfield General Hospital, Puyang 457001, Henan, China |
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| 期刊信息：《中国骨伤》2025年，第38卷，第2期，第183-187页 |
| DOI：10.12200/j.issn.1003-0034.20230993 |
| 基金项目:河南省医学科技攻关计划(联合共建)项目(编号:LHGJ20191374) |
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中文摘要:
目的: 探讨脊柱手术患者术后切口感染中术前中性粒细胞与淋巴细胞计数比值(neutrophil to lymphocyte ratio,NLR)、血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)、C反应蛋白(C-reactive protein,CRP)与白蛋白(albumin,ALB)比值的临床检测意义。
方法: 2020年6月至2023年5月行脊柱手术的373例患者,根据术后切口感染情况分为两组,切口感染组65例,男34例,女31例,年龄(56.01±9.78)岁;无切口感染组308例,男157例,女151例,年龄(55.54±10.19)岁。采用血细胞分析仪检测中性粒细胞、淋巴细胞和血小板,计算NLR、PLR;采用免疫比浊法测定血清CRP、ALB水平,计算CRP/ALB比值;采用受试者工作特征(receiver operating characteristic,ROC)曲线分析术前NLR、PLR及CRP/ALB比值对脊柱手术后切口感染的预测价值;采用Logistic多因素回归分析脊柱手术后切口感染的影响因素。
结果: 切口感染组术前NLR为4.92±1.13、PLR为119.32±22.74、CRP/ALB比值10.19±2.51、手术时间(3.02±0.64) h、糖尿病史(25/65,38.46%)、固定物置入患者比例(21/65,32.31%)均高于无切口感染组的3.72±0.81、90.58±20.16、7.23±2.21、(2.26±0.51) h、(53/308,16.88%)、(36/308,11.69%),差异有统计学意义(P<0.05)。术前NLR、PLR及CRP/ALB比值单独及联合预测脊柱手术后切口感染的AUC分别为0.786、0.806、0.839、0.926。术前NLR、PLR及CRP/ALB比值是脊柱手术后切口感染的独立危险因素(P<0.05)。
结论: 术前NLR、PLR及CRP/ALB比值测定有利于脊柱手术后切口感染的早期预测,三者联合检测可进一步提高预测结果的准确性。 |
| 【关键词】脊柱手术 切口感染 中性粒细胞与淋巴细胞计数比值 血小板与淋巴细胞比值 C反应蛋白与白蛋白比值 |
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| Predictive value of preoperative inflammatory response indicators for incisional infection after spinal surgery |
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ABSTRACT
Objective To explore the clinical significance of preoperative neutrophil to lymphocyte ratio (NLR),platelet to lymphocyte ratio (PLR),and C-reactive protein (CRP) to albumin (ALB) ratio in spinal surgery patients with postoperative incision infection.
Methods A total of 373 patients who underwent spinal surgery were collected and devided into two groups according to the postoperative incision infection situation. Among them,65 cases in the incision infection group included 34 males and 31 females with a mean age of (56.01±9.78) years old;308 cases in the non incision infection group included 157 males and 151 females with a mean age of (55.54±10.19) years old. Blood cell analyzer was applied to detect neutrophils,lymphocytes,and platelets,and calculate NLR and PLR;immunoturbidimetry was applied to measure serum CRP and ALB levels and calculate CRP/ALB ratio;receiver operating characteristic (ROC) curve was applied to analyze the predictive value of preoperative NLR,PLR,and CRP/ALB ratio for postoperative spinal incision infection;Logistic multivariate regression was applied to analyze the influencing factors of incision infection after spinal surgery.
Results The NLR(4.92±1.13),PLR (119.32±22.74),CRP/ALB ratio (10.19±2.51),operation time (3.02±0.64) h,history of diabetes 38.46%(25/65),and the proportion of patients with implant 32.31%(21/65) in the incision infection group were higher than those in the non incision infection group 3.72±0.81,90.58±20.16,7.23±2.21,(2.26±0.51) h,16.88%(53/308),11.69%(36/308),there were statistical differences(P<0.05). The AUC of preoperative NLR,PLR,and CRP/ALB ratio alone and in combination for predicting postoperative incision infection after spinal surgery was 0.786,0.806,0.839,and 0.926,respectively. Preoperative NLR,PLR,and CRP/ALB ratio were independent risk factors for postoperative incision infection in spinal surgery(P<0.05).
Conclusion The determination of preoperative NLR,PLR,and CRP/ALB ratio is beneficial for early prediction of postoperative spinal incision infection,and the combined detection of the three can further improve the accuracy of the prediction results. |
| KEY WORDS Spinal surgery Incision infection Neutrophil to lymphocyte ratio Platelet to lymphocyte ratio C-reactive protein to albumin ratio |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 梁维,卓瑞立,孙韶东.术前炎症反应指标对脊柱手术后切口感染的预测价值[J].中国骨伤,2025,38(2):183~187 |
| 英文格式: | LIANG Wei,ZHUO Rui-li,SUN Shao-dong.Predictive value of preoperative inflammatory response indicators for incisional infection after spinal surgery[J].zhongguo gu shang / China J Orthop Trauma ,2025,38(2):183~187 |
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