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C反应蛋白的早期术后价值:选择性肝切除术后预测或排除并发症的工具?
Michele Paterno1,2, Thibaud Bertrand1, Nicolas Golse1,3
1Department of Surgery, Centre Hepatobiliaire, Hôpital Paul Brousse, Villejuif, France.
World journal of surgery
|August 22, 2025
概括
肝切除后的C反应蛋白 (CRP) 含量对并发症的预测值较低. 不建议进行手术后CRP监测以指导患者在LR后的治疗.
科学领域:
- 肝胆外科手术
- 外科瘤学
- 术后护理
背景情况:
- 已知C反应蛋白 (CRP) 是一般腹部手术后并发症的预测因子.
- 在选择性肝切除 (LR) 后,其效用尚未得到充分证实.
- 这项研究研究了CRP在LR的预测性能.
研究的目的:
- 评估C反应蛋白 (CRP) 水平的预测性能.
- 评估CRP在选择性肝切除 (LR) 后预测并发症中的作用.
主要方法:
- 术后第一,第三和第五天的CRP值的回顾性分析.
- 包括448个选择性肝切除 (LR),并对腹腔镜和主要LR进行分组分析.
- 使用曲线下的面积 (AUC) 评估预测准确性.
主要成果:
- 在手术后的第三天观察到CRP的峰值.
- 在腹腔镜与开放式LR以及在POD3上主要与有限LR的CRP水平较低.
- 在POD1,3和5中严重并发症的预测值较低 (AUC<0. 65).
- 在69名POD3CRP<100 mg/ L的患者中,仅发生了2种主要并发症.
结论:
- 在切除肝脏后,术后的CRP水平 (POD 1, 3, 5) 缺乏足够的预测值.
- 在LR患者中,CRP不是指导术后治疗的可靠生物标志物.
- 需要进一步研究替代生物标志物或早期成像.
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