血清降钙素原水平预测肠梗阻导管治疗小肠梗阻转归的价值

Procalcitonin s predictive value for prognosis in patients receiving transnasal ileus tube therapy for small intestinal obstruction

目的 评价血清降钙素原水平预测肠梗阻导管治疗小肠梗阻转归的价值。方法 回顾性收集2020年1月至2022年9月徐州市中心医院收治的行肠梗阻导管置入治疗的小肠梗阻患者67例,根据肠梗阻导管置入前的血清降钙素原水平将患者分为高降钙素原组(H组)与正常降钙素原组(N组)。统计两组患者小肠梗阻的治疗效果并采用二元Logistic回归分析血清降钙素原水平与肠梗阻导管治疗效果的相关性。结果 67例患者中高降钙素原组15例,正常降钙素原组52例。肠梗阻导管置入后肠梗阻解除患者46例(H组6例,N组40例),治疗欠佳并中转外科手术患者21例(H组9例,N组12例)。肠梗阻解除患者中,N组患者置管后出现排气排便的中位时间(4 d)较H组(8 d)显著缩短,差异有统计学意义(P<0.05)。Logistic回归分析显示,高血清降钙素原水平是肠梗阻导管治疗小肠梗阻患者效果欠佳的独立危险因素(OR=5.000,95%CI为1.479~16.900,P=0.010)。结论 血清降钙素原水平能够预测肠梗阻导管治疗小肠梗阻的转归,PCT水平正常的小肠梗阻患者采用经鼻型肠梗阻导管治疗获益可能更大。

Objective The aim of this study is to assess the predictive power of serum procalcitonin(PCT)level in small intestinal obstruction patients before using ileus tube decompression therapy.Methods Selected were all 67 patients treated with an ileus tube for small intestinal obstruction at Xuzhou Central Hospital between January 2020 and September 2022.According to the serum procalcitonin level before catheterization of the ileus tube,the patients were divided into two groups:high procalcitonin group and normal procalcitonin group.The treatment effect of small bowel obstruction in each group was then calculated,and logistic regression analysis was used to assess the relationship between the serum procalcitonin level and the failure of conservative treatment.Results The 67 patients were divided into two groups:15 patients had high procalcitonin levels,52 had normal procalcitonin levels,and 46 patients had remarkable relief from intestinal obstruction symptoms(6 in the high procalcitonin group and 40 in the normal procalcitonin group).After conservative management failed,21 patients were referred for surgery(9 in the high procalcitonin group and 12 in the normal procalcitonin group).The normal procalcitonin group had a shorter median time to defecation than the high procalcitonin group(4 days vs.8 days)among patients receiving ileus tube treatment.These differences were statistically significant(P<0.05).Using an ileus tube to treat small intestinal obstruction,patients blood procalcitonin level was found to be an independent predictor of poor treatment outcomes(OR=5.000,95%CI 1.479~16.900,P<0.05)using logistic regression analysis.Conclusion Serum procalcitonin levels in patients with small bowel obstruction can be used to predict prognosis,and patients with normal procalcitonin levels may benefit more from transnasal ileus tube treatment.