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C反应蛋白和降钙素原在腹腔镜袖状胃切除术后早期检测术后并发症中的临床评估

Clinical evaluation of C-reactive protein and procalcitonin for the early detection of postoperative complications after laparoscopic sleeve gastrectomy.

作者信息

Frask Agata, Orłowski Michał, Dowgiałło-Wnukiewicz Natalia, Lech Paweł, Gajewski Krzysztof, Michalik Maciej

机构信息

General and Vascular Surgery Department, Ceynowa Hospital, Wejherowo, Poland.

Department of General and Minimally Invasive Surgery, University of Warmia and Mazury, Olsztyn, Poland.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2017 Jun;12(2):160-165. doi: 10.5114/wiitm.2017.67678. Epub 2017 May 12.

Abstract

INTRODUCTION

Among the most common early complications after bariatric surgery are anastomosis leak and bleeding. In order to react quickly and perform accurate treatment before the clinical signs appear, early predictors should be found. In the study C-reactive protein (CRP) and procalcitonin (PCT) levels were investigated. Characterized by a relatively short half-life, they can predict surgical complications.

AIM

To develop and implement certain standards for early detection of complications.

MATERIAL AND METHODS

The study involved 319 adults who underwent laparoscopic sleeve gastrectomy (LSG) as a surgical intervention for morbid obesity at the Department of General Surgery of Ceynowa Hospital in Wejherowo. Every patient had CRP and PCT levels measured before the surgery and on the 1 and 2 postoperative day (POD).

RESULTS

Early postoperative complications occurred in 19 (5.96%) patients. Septic and non-septic complications occurred in 3 and 16 patients respectively. Among the patients with septic postoperative complications CRP level increased significantly on the 2 POD compared to the remainder (p = 0.0221). Among the patients with non-septic postoperative complications CRP level increased significantly on the 1 and 2 POD compared to the remainder. Among the patients with septic and non-septic postoperative complications PCT level increased significantly on the 2 POD compared to the remainder.

CONCLUSIONS

The CRP and PCT level are supposed to be relevant diagnostic markers to predict non-septic and septic complications after LSG.

摘要

引言

减肥手术后最常见的早期并发症包括吻合口漏和出血。为了在临床症状出现之前迅速做出反应并进行准确治疗,应找到早期预测指标。在这项研究中,对C反应蛋白(CRP)和降钙素原(PCT)水平进行了调查。它们具有相对较短的半衰期,可预测手术并发症。

目的

制定并实施早期并发症检测的特定标准。

材料与方法

该研究纳入了319名成年人,他们在韦耶罗沃的采诺瓦医院普通外科接受了腹腔镜袖状胃切除术(LSG),作为治疗病态肥胖的手术干预措施。每位患者在手术前以及术后第1天和第2天(POD)测量了CRP和PCT水平。

结果

19名(5.96%)患者出现了术后早期并发症。分别有3名和16名患者出现了感染性和非感染性并发症。在术后发生感染性并发症的患者中,与其余患者相比,术后第2天CRP水平显著升高(p = 0.0221)。在术后发生非感染性并发症的患者中,与其余患者相比,术后第1天和第2天CRP水平显著升高。在术后发生感染性和非感染性并发症的患者中,与其余患者相比,术后第2天PCT水平显著升高。

结论

CRP和PCT水平应该是预测LSG术后非感染性和感染性并发症的相关诊断标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cd3/5502341/cd4c3985ac7c/WIITM-12-29913-g001.jpg

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