C反应蛋白和腹腔细胞因子作为结直肠手术后吻合口漏早期预测指标的价值
The Value of C-Reactive Protein and Peritoneal Cytokines as Early Predictors of Anastomotic Leak after Colorectal Surgery.
作者信息
Mužina Dubravka, Kopljar Mario, Bilić Zdenko, Davidović Blaženka Ladika, Glavčić Goran, Janković Suzana, Mačkić Monika
机构信息
Department of Surgery, University Hospital Center Sisters of Charity, 10000 Zagreb, Croatia.
Faculty of Medicine Osijek, University Hospital Sisters of Charity, Zagreb and Josip Juraj Strossmayer University of Osijek, 10000 Zagreb, Croatia.
出版信息
Diagnostics (Basel). 2024 Sep 23;14(18):2101. doi: 10.3390/diagnostics14182101.
OBJECTIVES
The aim of this study was to evaluate the accuracy of serum C-reactive protein (CRP) and intraperitoneal CRP, interleukin-6, and tumor necrosis factor-alpha in early diagnostics of anastomotic leakage in the first 4 postoperative days after colorectal surgery.
METHODS
Between January 2023 and June 2023, one hundred patients with colorectal carcinoma were operated on with primary anastomosis. Ten patients had anastomotic leak (10%).
RESULTS
Based on serum CRP, a patient with a leak will be detected with a 78% probability on postoperative day 3 with values above 169.0 mg/L and on postoperative day 4 with values equal to 159.0 mg/L and above. Intraperitoneal CRP values greater than 56 mg/L on the fourth postoperative day indicate a 78% probability of a diagnosis of leakage. An anastomotic leak will be detected with a 70.0% probability based on an IL-6 value on the first day, at a cut-off value of 42,150. The accuracy of TNF-alpha in predicting anastomotic leak in the first two days is 70% at values higher than 78.00 on the first and 58.50 on the second postoperative day.
CONCLUSION
In this study serum CRP proved to be the most accurate in predicting anastomotic dehiscence after colorectal surgery.
目的
本研究旨在评估血清C反应蛋白（CRP）、腹腔内CRP、白细胞介素-6和肿瘤坏死因子-α在结直肠手术后4天内吻合口漏早期诊断中的准确性。
方法
2023年1月至2023年6月，对100例结肠癌患者进行了一期吻合手术。10例患者发生吻合口漏（10%）。
结果
根据血清CRP，术后第3天CRP值高于169.0 mg/L、术后第4天CRP值等于或高于159.0 mg/L时，检测到吻合口漏患者的概率为78%。术后第4天腹腔内CRP值大于56 mg/L时，诊断吻合口漏的概率为78%。基于第1天IL-6值（临界值为42,150）检测到吻合口漏的概率为70.0%。术后第1天TNF-α值高于78.00、第2天高于58.50时，其预测前2天吻合口漏的准确率为70%。
结论
在本研究中，血清CRP被证明是预测结直肠手术后吻合口裂开最准确的指标。
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