Sabroe Jonas E, Axelsen Anne R, Ellebæk Mark B, Dahler-Eriksen Bjarne, Qvist Niels
Department of Surgery, Odense University Hospital, 5000, Odense C, Denmark.
Department of Anaesthesiology and Intensive Care, Odense University Hospital, 5000, Odense C, Denmark.
BMC Res Notes. 2017 Jul 21;10(1):302. doi: 10.1186/s13104-017-2622-9.
Secondary peritonitis is a condition associated with high morbidity and mortality. Continuous postoperative monitoring of patients to ensure timely intervention to treat complications without delay is important for survival and outcome. We aimed to (1) investigate potential differences in postoperative intraperitoneal biomarker levels between patients with upper and lower gastrointestinal tract lesion, and (2) compare postoperative biomarker levels between complicated and uncomplicated patients.
We included a total of 15 consecutive patients operated for upper (n = 7) and lower (n = 8) gastrointestinal tract perforation. We registered postoperative complications during a 30 days follow up-period. Complications were defined as intraabdominal complications, septic shock, and mortality. 5 patients were complicated. A microdialysis catheter was placed intraperitoneally in each patient. Samples were collected every 4th hour for up to 7 postoperative days. Samples were analysed for concentrations of glucose, lactate, pyruvate and glycerol.
Microdialysis results showed that patients with upper gastrointestinal tract lesions had significantly higher levels of postoperative intraperitoneal glucose and glycerol concentrations, as well as lower lactate/pyruvate ratios and lactate/glucose ratios. In the group with perforation of the lower gastrointestinal tract, those patients with a complicated course showed lower levels of postoperative intraperitoneal glucose concentration and glycerol concentration and higher lactate/pyruvate ratios and lactate/glucose ratios than those patients with an uncomplicated course.
Patients with upper and lower gastrointestinal tract lesions showed differences in postoperative biomarker levels. A difference was also seen between patients with complicated and uncomplicated postoperative courses.
继发性腹膜炎是一种发病率和死亡率都很高的疾病。术后持续监测患者，以确保及时干预治疗并发症而不延误，这对患者的生存和预后至关重要。我们旨在：（1）研究上消化道和下消化道病变患者术后腹腔内生物标志物水平的潜在差异；（2）比较有并发症和无并发症患者的术后生物标志物水平。
我们纳入了连续15例因上消化道（n = 7）和下消化道（n = 8）穿孔而接受手术的患者。我们记录了30天随访期内的术后并发症。并发症定义为腹腔内并发症、感染性休克和死亡。5例患者出现并发症。在每位患者的腹腔内放置一根微透析导管。术后7天内每4小时采集一次样本。对样本进行葡萄糖、乳酸、丙酮酸和甘油浓度分析。
微透析结果显示，上消化道病变患者术后腹腔内葡萄糖和甘油浓度显著更高，乳酸/丙酮酸比值和乳酸/葡萄糖比值更低。在下消化道穿孔组中，与无并发症的患者相比，有并发症的患者术后腹腔内葡萄糖浓度和甘油浓度更低，乳酸/丙酮酸比值和乳酸/葡萄糖比值更高。
上消化道和下消化道病变患者术后生物标志物水平存在差异。有并发症和无并发症的术后病程患者之间也存在差异。
