排水液calprotectin的升高是结直肠外科手术中早期解剖漏的预测因素
Limian Ling1, Zhongchao Zuo1, Ying Lv2
1Department of Colorectal Surgery and Oncology (Key Laboratory of Cancer Prevention and Intervention, National Ministry of Education), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310009, China.
World journal of surgical oncology
|June 23, 2025
概括
外科手术期间的排水液calprotectin有效地预测结直肠手术后的静脉漏 (AL). 在术后第3天的升高水平显示了对早期AL检测的高灵敏度和特异性,改善了患者的治疗结果.
科学领域:
- 结肠直肠外科手术是什么意思
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 肠道漏 (AL) 是结直肠癌手术后的一个关键并发症,显著增加了术后死亡率.
- 早期发现AL对于有效管理和改善患者存活率至关重要.
研究的目的:
- 为了评估外科手术期间排水液calprotectin在预测结直肠切除后的静脉并发症的诊断准确性.
- 为了比较calprotectin的实用性与传统的炎症标记物,如C反应蛋白 (CRP) 和互白素-6 (IL-6).
主要方法:
- 一项前性研究,对306名患者进行前切除,以治疗西格结肠或直肠癌.
- 患者被分为两组:那些发展AL (n=25) 和那些没有 (n=281) 的患者.
- 排水液中calprotectin,血清CRP和IL-6水平被测量并在各组之间进行比较.
主要成果:
- 在术后的第3天和第11天 (平均7天) 之间诊断出解剖管泄漏.
- 从术后第三天开始,在AL组观察到显著更高的排水液calprotectin水平 (207比96ng/mL,p < 0.0001).
- 在术后第3天,calprotectin水平>110 ng/mL,在临床前AL检测中达到92%的灵敏度和82%的特异性.
结论:
- 排水液calprotectin的早期和持续的升高是结肠直肠手术后道泄漏的重要预测因素.
- 在早期预测AL方面,calprotectin显示出与CRP和IL-6相比的潜在优势.
- 这些发现可以指导改进术后管理策略,并提高患者的治疗结果.
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