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外科手术对重度烧伤患者C反应蛋白水平的影响:早期脓毒症诊断意义的初步分析

Influence of Surgical Procedures on C-Reactive Protein Levels in Severely Burned Patients: Preliminary Analysis on Implications for Early Sepsis Diagnosis.

作者信息

Makowska-Rezaie Małgorzata Barbara, Jeleń Michał, Bartoszewicz Marzenna, Korzeniowski Tomasz, Klimeczek-Chrapusta Maria Kamila, Chrapusta Anna Marta

机构信息

Malopolska Burn and Plastic Surgery Center, Ludwik Rydygier Specialized Hospital, 31-826 Krakow, Poland.

Department of Immunopathology, Molecular Biology Faculty of Pharmacy, Wroclaw Medical University, 50-368 Wroclaw, Poland.

出版信息

Int J Mol Sci. 2025 May 28;26(11):5158. doi: 10.3390/ijms26115158.

Abstract

The local treatment of deep burn wounds involves the excision of the necrosis and covering the wounds with skin grafts. Surgical procedures are thought to have an impact on the inflammatory response, especially in severe burn patients requiring treatment in an intensive care unit. Currently, there are no available data in the literature regarding the correlation of the type of surgical procedure and the levels of the inflammatory markers. This study investigates the importance of monitoring c-reactive protein (CRP) around the time of surgical burn procedures and how it can aid in assessing the inflammatory response. Of the 810 burn patients, 93 patients aged 20 to 74 years with IIb- and III-degree burns covering 20% to 50% of the total burned body surface were included in this prospective study. Three subgroups were recognized based on the surgical procedure performed: fascial necrectomy, tangential necrectomy, and skin grafting. The research material included blood samples collected in the early postoperative hours. A total of 270 CRP level measurements were performed. A reduction in CRP levels was observed three hours post-procedure in patients who underwent skin harvesting for grafting. Conversely, a significant increase in CRP levels was noted between postoperative timepoints in patients who underwent tangential necrectomy.

摘要

深度烧伤创面的局部治疗包括切除坏死组织并用皮肤移植覆盖创面。手术操作被认为会对炎症反应产生影响,尤其是在需要在重症监护病房接受治疗的严重烧伤患者中。目前,文献中尚无关于手术操作类型与炎症标志物水平之间相关性的可用数据。本研究调查了在烧伤手术前后监测C反应蛋白(CRP)的重要性以及它如何有助于评估炎症反应。在810例烧伤患者中,本前瞻性研究纳入了93例年龄在20至74岁之间、IIb度和III度烧伤面积占全身烧伤总面积20%至50%的患者。根据所进行的手术操作确定了三个亚组:筋膜坏死组织切除术、削痂术和皮肤移植术。研究材料包括术后早期采集的血样。共进行了270次CRP水平测量。接受取皮移植的患者在术后三小时观察到CRP水平下降。相反,接受削痂术的患者在术后各时间点之间CRP水平显著升高。

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