Department of Surgery, Isala Clinics, Zwolle, The Netherlands.
Am J Surg. 2011 Nov;202(5):583-9. doi: 10.1016/j.amjsurg.2010.10.019. Epub 2011 Sep 3.
Abdominal surgery is a major oxidative stress effector. The increase in oxidative stress has been related to postoperative complications. Oxidative stress leads to the formation and accumulation of oxidation protein end products, which exhibit autofluorescence (AF) and induce inflammatory reactions.
Skin AF was assessed perioperatively in 40 consecutive colorectal surgery patients until discharge. Duration of surgery, estimated blood loss, and urinary production per hour were analyzed as measures of surgical stress. The clinical occurrence of anastomotic leakage, systemic infections, and cardiopulmonary complications within 30 days of surgery were analyzed.
A perioperative increase in skin AF of 19 ± .2% was observed. Duration of operation and blood loss were independently associated with the perioperative increase in skin AF. Skin AF correlated with C-reactive protein levels postoperatively. American Society of Anesthesiologists classification, duration of operation, and preoperative and perioperative increases in AF were independently associated with postoperative complications.
This is the first study to demonstrate an association between skin AF and surgical stress and outcomes, which may rate the condition of a patient after operation.
腹部手术是一种主要的氧化应激效应器。氧化应激的增加与术后并发症有关。氧化应激导致氧化蛋白终产物的形成和积累，这些产物表现出自发荧光（AF）并引发炎症反应。
在 40 例连续的结直肠手术患者中，在围手术期评估皮肤 AF，直到出院。分析手术时间、估计失血量和每小时尿量作为手术应激的指标。分析术后 30 天内吻合口漏、全身感染和心肺并发症的临床发生情况。
观察到皮肤 AF 增加了 19±2%。手术时间和失血量与皮肤 AF 的围手术期增加独立相关。皮肤 AF 与术后 C 反应蛋白水平相关。美国麻醉师协会分级、手术时间以及术前和围手术期 AF 的增加与术后并发症独立相关。
这是第一项研究表明皮肤 AF 与手术应激和结果之间存在关联，这可能可以评估患者术后的状况。
