术后第四天C-反应蛋白的实用性,以检测除了静脉切裂外的并发症
David Ortiz-López1,2, Joaquín Marchena-Gómez3,4, Yurena Sosa-Quesada3
1Department of General and Digestive Surgery, University Hospital of Gran Canaria Doctor Negrín, Barranco de la Ballena s/n, Las Palmas de Gran Canaria, Canary Islands, 35010, Spain. david.ortiz103@alu.ulpgc.es.
International journal of colorectal disease
|May 20, 2025
概括
术后第四天C反应蛋白 (CRP) 的升高预测了结直肠手术后的整体并发症. 低于42mg/L的CRP水平可靠地排除并发症,有助于临床决策.
科学领域:
- 手术瘤学手术瘤学
- 临床化学 临床化学
- 炎症标记物 炎症标记物
背景情况:
- 手术后的并发症在结直肠癌手术后显著影响患者的康复.
- C-反应蛋白 (CRP) 是一种已知的炎症标记物,先前的研究重点是其在预测静脉裂变中的作用.
- 有限证据表明CRP与整体术后并发症的频谱有关.
研究的目的:
- 调查第四次手术后的C-反应蛋白 (CRP) 水平与整体手术后并发症之间的关联.
- 评估CRP在使用综合并发症指数 (CCI) 预测并发症方面的实用性.
主要方法:
- 一项观察性研究涉及935名接受结直肠癌手术的患者 (2015-2022年).
- 根据并发症状况,患者被分为几组:没有,并发症不包括失传,并发症包括失传.
- 分析与并发症严重程度相关的CRP水平,并确定最佳CRP截止值.
主要成果:
- 各组的中位数CRP水平有显著差异:34.3 mg/L (没有并发症),69.9 mg/L (并发症不包括脱色) 和167.6 mg/L (脱色).
- 在CRP水平和术后并发症的发生/严重程度之间观察到显著的正相关性 (p < 0.001).
- 确定的CRP截止点:>58 mg/L (任何并发症),42-58 mg/L (不包括消声症的并发症),<42 mg/L (不包括82%负预测值的并发症).
结论:
- 术后第4天CRP水平升高表明整体术后并发症,不仅仅是静脉裂变.
- 综合并发症指数 (CCI) 评分和CRP水平之间存在直接相关性.
- 在术后第4天的CRP水平<42 mg/L是排除任何术后并发症存在的可靠指标.
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