内镜下胃隆起病变切除术后高敏C反应蛋白水平升高与并发症发生的关系

Relation between postoperative high sensitive C-reactive protein elevation and complications after endoscopic resection of gastric eminence lesions

目的探讨内镜下胃隆起病变切除术后患者高敏C反应蛋白(hs-CRP)水平升高与并发症的关系。方法选取2017年1月至2019年1月于潍坊医学院附属医院行内镜下胃隆起病变切除术的患者490例,完全随机分为对照组和观察组,每组245例。对照组患者均给予基础处理;观察组中术后hs-CRP升高(> 10 mg/L)患者给予基础处理+干预处理(抗菌、延长禁饮食时间等),余患者予基础处理。2组均检测术前1 d、术后第1天、术后第3天血清hs-CRP水平。统计2组术后并发症的发生率。结果观察组和对照组患者术前hs-CRP水平接近(P=0. 10),术后第1天hs-CRP水平均较术前明显升高[(4. 8±4. 7) mg/L比(1. 8±1. 3) mg/L、(5. 7±5. 4) mg/L比(2. 0±1. 4) mg/L](均P <0. 01),但组间比较差异无统计学意义(P=0. 07)。观察组中85例术后第1天hs-CRP升高,术后第3天复查时较术后第1天明显下降[(2. 3±1. 5) mg/L比(16. 3±5. 3) mg/L](P <0. 01);对照组79例术后第1天hs-CRP升高,术后第3天hs-CRP水平下降不明显[(16. 4±5. 6) mg/L比(16. 5±5. 6) mg/L](P=0. 83)。观察组并发症发生率明显低于对照组[3. 3%(8/245)比7. 8%(19/245)](P=0. 03)。结论检测内镜下胃隆起病变切除术患者术后第1天的hs-CRP水平,对术后hs-CRP升高者进行相应干预,可有效降低术后并发症的发生率。

Objective To investigate the relation between postoperative high sensitive C-reactive protein( hs-CRP) elevation and complications after endoscopic resection of gastric eminence lesions. Methods Totally490 patients undergoing endoscopic resection of gastric eminence lesions in Affiliated Hospital of Weifang Medical University from January 2017 to January 2019 were randomly divided into control group and observation group,with245 cases in each group. The control group had routine postoperative treatments. In the observation group,patients with postoperative serum hs-CRP elevation( > 10 mg/L) were treated with routine treatments combined with antibacterial drugs and long fasting time;the other patients had routine postoperative treatments. Serum level of hs-CRP was tested before operation and on the 1 st and 3 rd day after operation. Occurrence of postoperative complications was observed. Results Serum level of hs-CRP was similar between groups before operation( P =0. 10). On the 1 st day after operation,hs-CRP level significantly increased in both groups[observation group:( 4. 8 ± 4. 7) mg/L vs( 1. 8 ± 1. 3) mg/L,control group:( 5. 7 ± 5. 4) mg/L vs( 2. 0 ± 1. 4) mg/L]( both P <0. 01),but there was no statistical difference between groups( P = 0. 07). In the observation group,85 patients had hs-CRP elevation on the 1 st after operation,which significantly declined on the 3 rd day[( 2. 3 ± 1. 5) mg/L vs( 16. 3 ± 5. 3) mg/L]( P < 0. 01);hs-CRP elevation in 79 patients showed no significant improvement in the control group[( 16. 4 ± 5. 6) mg/L vs( 16. 5 ± 5. 6) mg/L]( P = 0. 83). Incidence of postoperative complications in the observation group was significantly lower than that in the control group[3. 3%( 8/245) vs 7. 8%( 19/245) ]( P = 0. 03). Conclusion Patients with serum hs-CRP elevation on the 1 st day after endoscopic resection of gastric eminence lesions need reasonable intervention to prevent complications.