骨科术后急性时相蛋白变化规律的研究

目的 为了了解骨科不同类型手术后急性时相蛋白的变化规律,增加术后护理观察指标。方法 对40例骨科术后病人根据手术方式分为3组,并分别于手术后第2、7、10、14天进行急性进相蛋白检查。结果 软组织术后仅CRP轻度增高,且在7天内恢复正常;部分涉及骨骼组与骨关节手术组术后除CER外,其余急性时相蛋白均增高,2天达最高峰,但在10～14天内恢复正常,而术后感染病人有3项急性时相蛋白增高,呈现双峰特征,且持续至21天后才基本恢复正常。结论 术后急性时相蛋白检查是一种判断感染的有价值的观察指标,应用急性时相蛋白判断术后感染应依骨科不同类型的手术而有不同标准。

Study on the Variation Regularity of Acutephase Proteins after Orthopedic Operation

Objective In order to investigate the regular pattern of the acutephase proteins after orthopedic operation. Methods 40 patients were divided into three groups according to the kinds of operation. The acutephase proteins were tested in the day of the second, 7th, 10th and 14th after operation. Results Only CRP was increased in the group of soft tissue operation, and returned to normal within 7 days. All acutephase proteins except CER rose to peak with in 2 days in the group of bone and joint operation, and fell back within 10-14 days. The change scale in the group partly involving bone operation was confined between the two groups. On the other hand, three acutephase proteins were increased for 21 days in four patients who were infected following surgery. Conclusions It was suggested that besides the clinical nursing observation, the change of acutephase proteins after operation was veryuseful to monitor postoperative infection. Generally, the acutephase proteins were raised higher after operation in group involved in bone or joint than in group involved in soft tissue, and the limitation of time back to normal was 7 days in soft tissue operation, 10 to 14 days in the other two groups.