【摘要】 目的 探讨持续性检测白细胞介素-6(IL-6)、中性粒细胞群落参数(NE-CPD)联合皮肤温度变化对膝关节置换术后早期感染的预测价值。方法 选取2020年3月—2022年3月于河南省郑州市第六人民医院接受人工膝关节置换手术治疗的85例老年患者,根据术后3个月内是否发生膝关节假体感染分为感染组(n=7)与未感染组(n=78)。比较2组患者术前、术后1 d、术后7 d、术后1个月、术后3个月血清IL-6、血液NE-CPD及膝关节手术部位周围皮肤温度。结果 2组患者术前及术后1 d血清IL-6水平比较,差异均无统计学意义(P>0.05);未感染组患者术后7 d、术后1个月、术后3个月血清IL-6水平低于感染组,差异均有统计学意义(P<0.05)。2组患者术前NE-CPD相关参数比较,差异均无统计学意义(P>0.05)。2组患者术后1 d的体积均值(MN-V-NE)均高于术前,术后7 d的MN-V-NE均低于术后1 d,术后1个月MN-V-NE均低于术后7 d,差异均有统计学意义(P<0.05);感染组患者术后3个月MN-V-NE高于术后1个月,差异有统计学意义(P<0.05);未感染组患者术后1 d、7 d、1个月、3个月MN-V-NE均低于感染组,差异均有统计学意义(P<0.05)。2组患者术前及术后不同时间点组间及组内传导性均值(MN-C-NE)比较,差异均无统计学意义(P>0.05)。感染组患者术后3个月中位角光散射均值(MN-MALS-NE)低于术前,差异有统计学意义(P<0.05);感染组患者术后1个月、3个月MN-MALS-NE低于未感染组,差异均有统计学意义(P<0.05)。感染组患者术后3个月高中位角光散射均值(MN-UMALS-NE)低于术前及未感染组,差异均有统计学意义(P<0.05)。感染组患者术后3个月低中位角光散射均值(MN-LMALS-NE)低于未感染组,差异有统计学意义(P<0.05)。感染组患者术后1个月、3个月轴向光吸收均值(MN-AL2-NE)低于未感染组,差异均有统计学意义(P<0.05)。2组患者术前及术后不同时间点手术部位周围皮肤温度比较,差异有统计学意义(P<0.05);感染组患者术后不同时间点手术部位周围皮肤温度均高于术前,差异均有统计学意义(P<0.05);未感染组患者术前及术后各时间点皮肤温度两两比较,差异均无统计学意义(P>0.05);未感染组患者术后不同时间点手术部位周围皮肤温度均低于感染组,差异均有统计学意义(P<0.05)。结论 膝关节置换术后持续检测IL-6、NE-CPD及手术部位周围皮肤温度变化对术后感染的发生有较好预测价值,有助于预防术后感染,降低感染发生风险。更多还原

【Abstract】 Objective To investigate the predictive value of continuous detection of interleukin-6(IL-6) and neutrophil cell population data(NE-CPD) parameters combined with skin temperature changes for early infection after knee arthroplasty. Methods Eighty-five elderly patients who underwent total knee arthroplasty in the Sixth People’s Hospital of Zhengzhou from March 2020 to March 2022 were selected and assigned to the infected(n=7) and uninfected groups(n=78) following the presence or absence of knee prosthesis infection 3 months after surgery. Serum IL-6, blood NE-CPD-related parameters, and skin temperature around the knee joint surgical site were compared between the two groups before surgery, 1 d, 7 d, 1 month, and 3 months after surgery. Results There was no significant difference in serum IL-6 levels before the operation and 1 d after the operation between the two groups(P>0.05); the serum IL-6 levels at 7 d, 1 month, and 3 months after the operation in the uninfected group were significantly lower than those in the infected group(P<0.05). There were no significant differences in NE-CPD-related parameters between the 2 groups before surgery(P>0.05). mean volumec(MNV-NE) at 1 d after the operation in both groups was significantly higher than that before the operation, MN-V-NE at 7 d after the operation was lower than that at 1 d after the operation, and MN-V-NE at 1 month after the operation was lower than that at 7 d after the operation, with satistical significance(P<0.05). MN-V-NE at 3 months after operation in the infected group was higher than that at 1 month after the operation, and the differences were statistically significant(P<0.05). MNV-NE at 1 d, 7 d, 1 month, and 3 months after operation in the uninfected group was lower than that in the infected group, and the differences were statistically significant(P<0.05). There were no significant differences in mean conductivity(MNC-NE) between and within groups at different time points before and after surgery between the 2 groups(P>0.05). mean of median angle light scattering(MN-MALS-NE) at 3 months after the operation in the infection group was significantly lower than that before the operation(P<0.05); MN-MALS-NE at 1 month and 3 months after the operation in the infection group was significantly lower than that in the uninfected group(P<0.05). Patients in the infected group had significantly lower mean of high median angle light scatting(MN-UMALS-NE) 3 months after surgery than those in the preoperative and uninfected groups(P<0.05). Patients in the infected group had significantly lower mean of low median angle light scattering(MN-LMALS-NE) 3 months after surgery than those in the uninfected group(P<0.05). Patients in the infected group had significantly lower mean axial light absorption(MN-AL2-NE) than those in the uninfected group at 1 and 3 months after surgery(P<0.05). Significant differences were observed in the skin temperature around the surgical site between the two groups at different time points before surgery and after surgery(P<0.05). The skin temperature around the surgical site at different time points after surgery in the infected group was significantly higher than that before surgery(P<0.05). No significant differences were observed in the skin temperature between the two groups at different time points before and after surgery in the uninfected group(P>0.05). The skin temperature around the surgical site at different time points after surgery in the uninfected group was significantly lower than that in the infected group(P<0.05).Conclusion Continuous detection of IL-6,NE-CPD,and skin temperature around the operation site after knee arthroplasty has a good predictive value for the occurrence of postoperative infection,which is helpful to prevent postoperative infection and reduce the risk of the infection.更多还原