期刊文献+

血浆降钙素原对结直肠癌术后肠梗阻中的预测作用 被引量:10

Plasma procalcitonin levels for prediction of postoperative ileus following colorectal cancer surgery
原文传递
导出
摘要 目的:探讨结直肠癌手术后患者血浆中细胞因子水平的变化与术后肠梗阻的关系。方法:选择100例行乙状结肠癌或直肠癌根治术的患者,在术后第1,3,5天抽取患者的静脉血,检测降钙素原(PCT),C反应蛋白(CRP)和肿瘤坏死因子α(TNF-α)水平。根据患者术后是否发生肠梗阻,将患者分为肠梗阻组与非肠梗阻组,比较两组术前、术中、术后情况,以及术后上述细胞因子的水平。结果:8位患者在术后第10~15天出现肠梗阻。肠梗阻组的首次排气时间明显长于非肠梗阻组(P〈0.05),其他临床变量如年龄、性别、体质量指数、肿瘤部位、术中出血量、手术时间、术后住院时间两组间差异均无统计学意义(均P〉0.05);两组术后第1,3天PCT水平无统计学差异(均P〉0.05),但肠梗阻组术后第5天PCT水平明显升高,与非肠梗阻组比较差异有统计学意义(P=0.014);两组术后CRP和TNF-α水平变化趋势基本一致,各时间点差异均无统计学意义(均P〉0.05)。结论:结直肠癌术后患者血浆中PCT水平的升高可能是1项早期预测术后肠梗阻的实验室指标。 Objective: To investigate the relationship between changes of the plasma cytokine levels and the occurrence of postoperative ileus in patients after radical resection for colorectal cancer. Methods: One hundred consecutive patients undergoing radical resection for sigmoid or rectal cancer were selected. Venous blood samples were drawn from the patients on postoperative day (POD) 1, 3 and S formeasurement of the plasma levels of procalcitonin (PCT), C-reactive protein (CRP) and tumor necrosis α (TNF-α). The sub)ects were divided into ileus group and non-ileus group according to whether an ileus was present, and the pre-, intra- and postoperative conditions, as well as the levels of above cytokines were compared between the two groups. Results: Ileus occurred in 8 of the patients on POD 10 to 15. The time to first flatus passage in ileus group was significantly longer than that in non-ileus group, but other variables that included age, sex, body mass index, tumor site, intraoperative blood loss, operative time and length of postoperative hospital stay showed no significant difference between the two groups (all P〉0.05). The PCT levels on POD 1 and 3 were not significantly different between the two groups (P〉0.05), but it was remarkably increased on POD 5 in ileus group and the difference reached significant significance versus non-ileus group (P=0.014). She changes of postoperative CRP and TNF-ct level in the two groups showed a similar tendency, and the differences between the two groups at each time point had no statistical significance (all P〉0.05). Conclusion: Increased plasma PCT level may be a laboratory indicator for early prediction of the occurrence of postoperative ileus following colorectal carcinoma surgery.
出处 《中国普通外科杂志》 CAS CSCD 北大核心 2013年第10期1319-1323,共5页 China Journal of General Surgery
基金 上海市科委基础研究重点资助项目(10DJ1400504)
关键词 结直肠肿瘤 外科学 肠梗阻 手术后并发症 预防与控制 细胞因子类 Colorectal Neoplasms/surg Intestinal Obstruction Postoperative Complications Cytokines
  • 相关文献

参考文献20

  • 1Bauer AJ, Boeckxstaens GE. Mechanisms of postoperative ileus[J]. Neurogastroenterol Motil, 2004,16(Suppl 2):54-60.
  • 2许超,池畔.腹腔镜与开腹结直肠癌根治术后肠梗阻发生率比较的Meta分析[J].中华胃肠外科杂志,2012,15(10):1044-1047. 被引量:23
  • 3Hesse DG, Tracey K J, Fong Y, et al. Cytokine appearance in human endotoxemia and primate bacteremia[J]. Surg Gyneco! Obstet, 1988, 166(2): 147-153.
  • 4Jansson K, Redler B, Truedsson L, et al. Intraperitoneal cytokine response after major surgery: higher postoperative intraperitoneal versus systemic cytokine levels suggest the gastrointestinal tract as the major source of the postoperative inflammatory reaction [J]. Am J Surm 2004. 187(3:372-'77.
  • 5Castell JV, Andus T, Kunz D, et al. Interleukin-6. The major regulator of acute-phase protein synthesis in man and rat [J]. Ann N Y Acad Sci. 1989. 557:87-99.
  • 6Artinyan A, Nunoo-Mensah JW, Balasubramaniam S, et al. Prolonged postoperative ileus-definition, risk factors, and predictors after surgery[J]. World J Surg, 2008, 32(7): 1495-1500.
  • 7Herwig R, Glodny B, Ktihle C, et al. Early identification of peritonitis by peritoneal cytokine measurement[J]. Dis Colon Rectum, 2002, 45(4):514-521.
  • 8王斌,李宏艳.术后早期炎性肠梗阻的诊断与治疗[J].中国普通外科杂志,2002,11(8):479-480. 被引量:36
  • 9陈正煊,陈创奇,彭俊生,卢砺锋.直肠癌术后早期肠梗阻的临床特点和治疗[J].中国普通外科杂志,2000,9(4):344-346. 被引量:12
  • 10Jeong WK, Lira SB, Choi HS, et al. Conservative management of adhesive small bowel obstructions in patients previously operated on for primary colorectal cancer[J]. J Gastrointest Surg, 2008, 12(5):926-932.

二级参考文献27

  • 1张军明,任艳华,郑膺,张婵,刘芬,余正平,雷亚宁.腹部外科手术操作对大鼠肠道运动功能和肠神经系统的影响[J].解放军医学杂志,2007,32(2):127-130. 被引量:5
  • 2崔乃强,赵琪,葛智慧,殷宗福,靳殿功,孙新明,邱奇,张灼,张风云,房洁,吴咸中.通里攻下法治疗急腹症所致MODS的疗效观察[J].中国中西医结合外科杂志,1996,2(5):315-320. 被引量:74
  • 3赵连根,伍孝先,陈玉玲,朱柞铭,刘福森,陈家童.治疗急性胰腺炎中药筛选及药理作用研究[J].中国中西医结合外科杂志,1996,2(5):329-333. 被引量:62
  • 4Pickleman J,Lee RM.The management of patientswith suspected early postoperative small bowel obstruction[J].AnnSurg,1989,12(1):216-219.
  • 5Dan S,Elad F,Amis S,et al.How conservatively can postoperative small bowelobstruction be treated?[J].Am J Surg,1993,165(1):121-126.
  • 6Meagher AP,Moller C.Hoffmann DC.Non-operative treatment of small bowel obstructionfollowing appendicectomy or operation on the ovary or tube[J].Br JSurg,1993,80(10):1310-1311. 修订日期:2000-05-08
  • 7Lacy AM, Garcia-Valdecasas JC, Delgado S, et al.Laparoscopy-assisted colectomy versus open colectomy fortreatment of non-metastatic colon cancer: a randomised trial.Lancet, 2002,359(9325) :2224-2229.
  • 8Braga M, Vignali A, Gianotti L, et al. Laparoscopic versusopen colorectal surgery : a randomized trial on short-termoutcome. Ann Surg, 2002,236(6) :759-767.
  • 9Leung KL, Kwok SP, Lam SC, et al. Laparoscopic resection ofrectosigmoid carcinoma : prospective randomised trial. Lancet,2004,363(9416):1187-1192.
  • 10Veldkamp R, Kuhry E, Hop WC, et al. Laparoscopic surgeryversus open surgery for colon cancer: short-term outcomes of arandomised trial. Lancet Oncol, 2005,6(7) :477-484.

共引文献68

同被引文献103

引证文献10

二级引证文献72

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部