Evaristo-Méndez Gerardo, Gallegos-Sierra Cuauhtly, Cruz-Temores Salvador De La
Departamento de Cirugía General, Hospital Regional Dr. Valentín Gómez Farías, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Zapopan, Jalisco, México.
Cir Cir. 2019;87(1):45-52. doi: 10.24875/CIRU.18000420.
The purpose of this prospective cohort study was to evaluate whether serum procalcitonin (PCT) levels predict the need for surgery and the presence of ischemia and/or necrosis (I/N) in small bowel obstruction.
Of 54 patients included, conservative management was performed in 31 (non-surgical group) and an exploratory laparotomy in 23 (surgical group). The reference value of the PCT was between 0.10 and 0.50 ng/mL.
PCT levels were higher in the surgical group (7.05 ± 7.03 ng/mL) than in the non-surgical (0.37 ± 0.63 ng/mL), and in patients with I/N (10.06 ± 7.07 ng/mL) than without I/N (1.52 ± 1.45 ng/mL). In the ROC curve, the area under the curve was 0.91 for the need for surgery and 0.93 for I/N. PCT ≥ 0.80 ng/mL had the best sensitivity and specificity for surgery and ≥ 1.95 ng/mL for I/N. PCT was also an independent predictor for these events.
The levels of PCT can recognize the need for surgery and the presence of I/N in small bowel obstruction. Additional studies are needed to affirm or invalidate our findings.
这项前瞻性队列研究的目的是评估血清降钙素原（PCT）水平是否能预测小肠梗阻患者的手术需求以及缺血和/或坏死（I/N）的存在情况。
纳入的54例患者中，31例进行了保守治疗（非手术组），23例进行了剖腹探查术（手术组）。PCT的参考值在0.10至0.50 ng/mL之间。
手术组的PCT水平（7.05±7.03 ng/mL）高于非手术组（0.37±0.63 ng/mL），有I/N的患者（10.06±7.07 ng/mL）高于无I/N的患者（1.52±1.45 ng/mL）。在ROC曲线中，手术需求的曲线下面积为0.91，I/N的曲线下面积为0.93。PCT≥0.80 ng/mL对手术具有最佳的敏感性和特异性，≥1.95 ng/mL对I/N具有最佳的敏感性和特异性。PCT也是这些事件的独立预测因子。
PCT水平可识别小肠梗阻患者的手术需求以及I/N的存在情况。需要进一步的研究来证实或否定我们的发现。
