降钙素原是结直肠吻合口破裂的预测因素之一

Q4 Medicine Scripta Medica Pub Date : 2022-01-01 DOI:10.5937/scriptamed53-35544
J. Đeri, J. Ćulum, Zoran Aleksić, Dalibor Šaran, Romana Rajić
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引用次数: 0

摘要

背景/目的:结肠直肠吻合口破裂是消化手术中最严重的并发症之一,目前仍有很大比例存在,这大大增加了治疗费用,并可能导致死亡。综上所述,吻合口裂的早期发现以及手术治疗的决定是非常重要的。降钙素原(PCT)被认为是炎症和败血症的重要标志。本文旨在证实PCT在吻合口瘘的早期诊断中具有很高的敏感性。方法:研究纳入2016年至2020年期间接受结直肠癌手术治疗的患者。患者手术根据选择性方案和开放手术入路。在患者中,于术后第2天和第4天(POD)测量PCT值,以确定PCT值升高与结直肠吻合口开裂的发生之间的关系。结果:对118例采用吻合器结肠吻合术的患者进行了研究。结直肠吻合口裂开10例。4例裂孔患者不需再手术治疗,但均采取保守治疗。6例重复手术。所有裂孔患者的PCT值均高于正常值数倍。结论:PCT作为结直肠吻合口破裂的标志物具有较高的敏感性和特异性(分别为85%和74%)。本研究发现PCT值与吻合口第2 POD,尤其是第4 POD的开裂有显著相关性。
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Procalcitonin is one of the predictive factors of dehiscence of the colorectal anastomosis
Background/Aim: Dehiscence of the colorectal anastomosis is one of the most serious complications in digestive surgery that is still present in a large percentage today, which significantly increases the cost of treatment and can lead to death. Due to all the above, early detection of anastomotic dehiscence is very important, as well as the decision on surgical treatment. Procalcitonin (PCT) is thought to be an important marker of inflammation and sepsis. Aim of this paper was to confirm PCT as a marker of great sensitivity in early diagnosis of anastomotic leakage. Methods: The study included patients who underwent surgery for colorectal cancer in the period from 2016 to 2020. Patients were operated according to an elective protocol and with an open surgical approach. In patients, PCT values were measured on the 2nd and 4th postoperative day (POD) to determine the association between elevated PCT values and the onset of dehiscence of the colorectal anastomosis. Results: A study was conducted in 118 patients in whom a stapler colorectal anastomosis was created. Colorectal anastomosis dehiscence occurred in 10 patients. In 4 patients with dehiscence, no re-surgical intervention was required, but they were taken care of by conservative methods. Repeated surgery was performed in 6 patients. In all patients with dehiscence, there was a multiple increase in the value of PCT above normal. Conclusion: PCT has high sensitivity and specificity (85 and 74 % respectively) as a marker in dehiscence of colorectal anastomosis. In this study it was found that PCT values were significantly correlated with the dehiscence of anastomo-sis 2nd POD and especially 4th POD.
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13
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4 weeks
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