目的 探讨股骨颈骨折人工股骨头置换围术期红细胞沉降率和血清炎症因子含量的变化及其临床意义.方法 选取2013年5月～2015年5月于汕头市中医院拟行人工股骨头置换治疗的股骨颈骨折患者66例,检测其围术期红细胞沉降率和血清炎症因子含量的变化,术后均随访1年.结果 感染患者围术期红细胞沉降率和血清白介素6(IL-6)、肿瘤坏死因子α(TNF--α)和降钙素原(PCT)等炎症因子水平均较无感染患者升高,差异有统计学意义(P＜0.05);随访1年,Harris评分≥80分患者的围术期红细胞沉降率和血清炎症因子水平均较评分＜80分患者降低,差异有统计学意义(P＜0.05).股骨颈骨折人工股骨头置换围术期红细胞沉降率和血清IL-6、TNF-α和PCT水平与其感染发生率和Harris评分均相关(P＜0.05).ROC曲线分析结果显示,股骨颈骨折人工股骨头置换围术期红细胞沉降率和血清炎症因子水平联合诊断其感染的价值均较高;其围术期红细胞沉降率和血清炎症因子水平联合预测其髋关节功能恢复情况的价值亦良好.结论 股骨颈骨折人工股骨头置换围术期红细胞沉降率和血清炎症因子与其感染和髋关节功能密切相关,可能用于其感染和髋关节功能恢复情况评估.%Objective To study the changes of perioperative blood sedimentation and serum inflammatory cytokines concentrations in patients with femoral neck fracture and artificial femoral head replacement treatment and its clinical significance.Methods From May 2013 to May 2015,in Traditional Chinese Medical Hospital of Shantou City,66 patients with femoral neck fracture and artificial femoral head replacement treatment were selected,they were given postoperative 1 year follow-up.Perioperative blood sedimentation and serum inflammatory cytokines concentrations of the were detected.Results Perioperative blood sedimentation and serum IL-6,TNF-α and PCT and other inflammatory markers levels in patients with infection were higher than that of patients without infection,the differences were statistically significant (P ＜ 0.05).After 1 year follow-up,perioperative blood sedimentation and inflammatory markers levels in patients with Harris score ≥ 80 points were lower than that of patients with Harris score ＜80 points,the differences were statistically significant (P ＜ 0.05).Perioperative blood sedimentation and serum IL-6,TNF-α and PCT levels in patients with femoral neck fracture and artificial femoral head replacement treatment were correlated with the infection incidence and Harris scores (P ＜ 0.05).ROC curve analysis results showed that value of perioperative blood sedimentation and serum inflammatory factors levels in patient with femoral neck fracture and had artificial femoral head replacement treatment unitedly diagnosing the infection was high;and the value of perioperative blood sedimentation and serum inflammatory factors levels in patient with femoral neck fracture and had artificial femoral head replacement treatment unitedly predicting the hip function recovery was also good.Conclusion Perioperative blood sedimentation and serum inflammatory factors levels in patient with femoral neck fracture and had artificial femoral head replacement treatment are closely related to the infection and hip function,and it may help to evaluating the infection and the hip joint function recovery.
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