作为难以预测 laparoscopic 胆囊切除术的预测者,C反应性蛋白的作用
Khadija Anees1, Muhammad Faizan2, Sarush Ahmed Siddiqui2
1Department of General Surgery, Civil Hospital Karachi, Dow University of Health Sciences, Karachi, Pakistan.
Surgical innovation
|November 6, 2023
概括
血清C反应蛋白 (CRP) 有效地预测了困难的腹腔镜胆囊切除术. 较高的CRP水平 (>11 mg/dL) 表明手术内挑战和转换为开放手术的可能性更高.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 临床化学 临床化学
背景情况:
- 胆结石 (胆结石) 是一种普遍的胃肠道疾病.
- 困难的腹腔镜胆囊切除术是通过延长的手术时间或早期的囊性动脉损伤来定义的.
- 预测外科手术难度有助于准备,患者咨询和管理手术内并发症.
研究的目的:
- 评估血清C反应蛋白 (CRP) 对于难以进行腹腔镜胆囊切除术 (LC) 的预测值.
- 评估CRP的诊断准确性,以确定可能在LC期间遇到手术挑战的患者.
主要方法:
- 一项涉及269名被诊断患有胆病的患者进行的横截面研究.
- 通过非概率,连续抽样采集数据,获得机构审查委员会批准和知情同意.
- 分析了血清CRP水平,以预测手术困难,并按年龄,性别和BMI分层.
主要成果:
- 困难的LC的患病率为14.5% (39/269).
- 血清CRP显示了高的诊断准确性:87.2%的灵敏度,97%的特异性,82.9%的正预测值 (PPV),97.8%的负预测值 (NPV) 和95.5%的整体准确性.
- 与CRP<11 mg/dL (5/223) 患者相比,CRP>11 mg/dL的患者患有困难的LC的发生率显著更高 (34/41).
结论:
- 血清C反应蛋白是难以进行腹腔镜胆囊切除术的强有力的术前预测剂.
- 手术前CRP水平升高 (>11 mg/dL) 与手术后并发症增加以及转换为开放手术的可能性更高有关.
- CRP提供了良好的灵敏度,特异性,PPV和NPV,用于预测研究群体中难以预测的LC.
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