急诊腹部创伤早期SIRS评分及血清中C反应蛋白含量与创伤后感染的相关性分析

摘要

目的：研究急诊腹部创伤患者早期全身炎症反应综合征（SIRS）评分及血清中C反应蛋白含量与创伤后感染的相关性。方法：选取2011年1月～2013年1月间入院诊治的腹部创伤或腹部创伤为主的多发伤患者125例，所有患者入院后行紧急救治措施后均进行SIRS评分，并在伤后24h检测血清C反应蛋白的含量。根据患者是否感染分为感染组与非感染组，观察比较两组患者在SIRS评分与血清C反应蛋白含量差异。结果：125例患者中，创伤后感染的患者有18例，其中以呼吸系统感染最多，占55.56%。SIRS组与非SIRS组在年龄、性别等方面无显著差异，但ISS评分相对较高，感染组与非感染组在年龄、性别等方面无显著差异，但ISS评分相对较高；SIRS评分在3～4分者感染率显著高于SIRS评分＜3分者，经Logistic逐步回归危险性分析后，SIRS评分在3～4分者为腹部创伤患者感染的独立预测因素。125例患者创伤后24h CRP含量与ISS进行spearman相关分析后，两者相关系数为0.565，呈显著正相关。感染组CRP含量中位数为34.98mg/L、四分位数间距为41.85mg/L；非感染组分别为63.75mg/L、89.04mg/L，两组差异显著（P＜0.05）。结论：SIRS评分与创伤后24h CRP含量测定对于预测腹部创伤患者的感染有一定的临床参考价值。%Objective: To study the emergency abdominal trauma patients with early systemic inlfammatory response syndrome(SIRS) score and serum C-reactive protein levels after infection correlated with the trauma.Methods:January 2011~January 2013 between abdominal trauma or abdominal trauma hospitalized dominated the 125 cases of multiple trauma patients ,were performed in all patients after admission SIRS score underwent emergency treatment measures and detection 24h after injury serum C -reactive protein levels .Infection group and non- infected group were observed reactive protein levels were compared in patients with SIRS score differences according to whether patients with serum C infection divided. Results: 125 patients ,patients post-traumatic infection in 18 cases ,of which a maximum of respiratory infections,accounting for 55.56% .SIRS group with no non- SIRS group in age,gender and other aspects of signiifcant differences ,but the ISS score relatively high infection group and non- infected group were no signiifcant differences in age,gender ,etc.,but the ISS score relatively high; SIRS score at 3 1~4 points were signiifcantly higher infection rate SIRS score< 3 points ,after Logistic regression risk analysis,SIRS score were independent predictors of 3 to 4 points by abdominal trauma patient infection.125 patients after trauma 24h CRP levels and ISS performed spearman correlation analysis,the correlation coefifcient between the two was 0.565,showed a signiifcant positive correlation .Infection group median CRP levels 34.98mg/L,interquartile range 41.85mg/L; non-infected group were 63.75mg/L,89.04mg/L,the difference was signiifcant(P<0.05).Conclusion:24h CRP levels measured after SIRS score for predicting abdominal trauma and trauma patients infected with certain clinical reference value.