骨折患者内置入手术治疗前后血清C-反应蛋白变化的意义

目的探讨骨折患者内置入手术治疗前后血清C-反应蛋白(CRP)变化的意义。方法 200例行内置入手术治疗的骨折患者中,采用微创手术治疗109例(微创组),采用传统开放手术治疗91例(传统组)。比较两组患者术前及术后1、3、7 d血清CRP水平变化。然后依据术后是否发生感染,分为感染组(2例)和未感染组(198例),比较两组各时段血清CRP水平变化。结果术前血清CRP水平微创组和传统组比较差异无统计学意义(P0.05),术后各时段微创组均较传统组显著降低(P0.05)。与术前比较,微创组术后1、3 d和传统组术后各时段均显著升高(P0.05);与术后1 d比较,两组术后3、7 d均明显降低(P0.05)。术后2例患者发生感染,感染率为1%。感染组与未感染组比较,术前血清CRP水平差异无统计学意义(P0.05);与术前比较,感染组术后各时段、未感染组术后1、3 d血清CRP水平均明显升高(P0.05);与术后1 d比较,感染组术后3 d明显升高(P0.05),未感染组术后3、7 d均明显降低(P0.05)。结论采用微创内置入手术治疗骨折患者血清CRP变化幅度明显低于传统手术。血清CRP水平在术后感染患者中显著升高,可作为感染诊断的重要辅助指标。

Significance of the changes of serum C-reactive protein in patients with fractures after im-plantation surgery

Objective To explore the significance of the changes of serum C-reactive protein( CRP) in fractures pa-tients after implantation surgery. Methods The 200 cases of fractures patients who underwent implantation surgery, 109 cases with minimally invasive surgery ( minimally invasive group) ,and 91 cases with traditional open surgery ( traditional group). Then the CRP levels of patients before operation and at 1,3,7 d after operation were compared. The patiens were divided into infection group(2 cases) and non-infection group(198 cases),and the CRP levels were compared again at every time after operation. Results The difference in the levels of serum CRP was not statistically significant between the minimally invasive group and the traditional group ( P>0. 05 ) , and the minimally invasive group was significantly reduced than the traditional group at every time after operation(P<0. 05),and the minimally invasive group at 1,3 d after operation, and at every time after operation in the traditional group than those before op-eration were significantly increased(P<0. 05),and at 3,7 d after operation than those at 1 d after operation were sig-nificantly decreased(P<0. 05). There were 2 cases who happened infection after surgery,and the rate of infection was 1%. The levels of serum CRP between the infection group and non-infection group was not statistically significant (P>0. 05),compared with those before operation,the levels at every time after operation in the infection group and at 1,3 d in the non-infection group were significantly increased(P<0. 05). Compared with that after 1 d of operation, the level of the infection group at 3 d after operation was significantly incerased ( P<0. 05 ) , and the non-infection group at 3 d and 7 d after operation were significantly decreased ( P<0. 05 ) . Conclusions The changes of serum CRP levels by minimally invasive surgery in the treatment of patients with fractures are significantly lower than those by traditional operation,and the serum CRP levels are significantly increased in patients with postoperative infection, which can be used as an important indicator of infection diagnosis.