降钙素原和c反应蛋白:吻合口瘘早期诊断的标志物。

IF 0.5 4区医学 Q4 SURGERY

Cirugia Y Cirujanos Pub Date : 2023-01-01 DOI:10.24875/CIRU.22000116

Isadora G Maldonado-Hernández, Eduardo Vega-Chavarría, Yamir A Nacud-Bezies, Hid F Cordero-Franco, Gerardo C Palacios-Saucedo

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引用次数: 0

摘要

目的:探讨血清降钙素原(PCT)和c反应蛋白(CRP)在结直肠手术患者吻合口漏(AL)早期诊断中的价值。方法:在三级医院进行诊断试验。术前未检测PCT和CRP的患者被排除在外。排除与AL无关的术后感染。诊断效能指标为敏感性(Sn)、特异性(Sp)、阳性(PPV)和阴性(NPV)预测值、阳性(LR+)和阴性(LR-)似然比、受试者工作特征曲线下面积(AUROC)。结果:分析39例患者;AL 6例(15.4%)。术后第2天PCT和CRP升高，仅AL患者升高。术后第2天PCT和CRP的临界值分别为1.55 ng/mL和11.25 mg/L。术后第2天PCR检测最有效(AUROC: 1.00;Sn: 100%;Sp: 96.7%;PPV: 85.7%;净现值:100%;LR +: 33.0)。结论:术后第2天CRP是早期诊断结直肠手术患者AL最有效的检测指标，其临界值低于国际文献报道。

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Procalcitonin and C-reactive protein: markers in the early diagnosis of anastomotic leak.

Objective: To determine the efficacy of serum procalcitonin (PCT) and C-reactive protein (CRP) in the early diagnosis of anastomotic leak (AL) in patients undergoing colorectal surgery.

Method: Diagnostic test in a tertiary care hospital. Patients who did not have preoperative measurements of PCT and CRP were excluded. Those with postoperative infection not related to AL were eliminated. The diagnostic efficacy measures were sensitivity (Sn), specificity (Sp), positive (PPV) and negative (NPV) predictive values, positive (LR+) and negative (LR-) likelihood ratios, and area under the receiver operating characteristic curve (AUROC).

Results: Thirty-nine patients were analyzed; six had AL (15.4%). PCT and CRP increased on the second postoperative day, only in patients with AL. The cut-off points at the second postoperative day were 1.55 ng/mL for PCT and 11.25 mg/L for CRP. The most efficacious test was PCR at second postoperative day (AUROC: 1.00; Sn: 100%; Sp: 96.7%; PPV: 85.7%; NPV: 100%; LR+: 33.0).

Conclusions: CRP at second postoperative day was the most effective test in the early diagnosis of AL in patients undergoing colorectal surgery, with a cut-off point lower than that reported in the international literature.

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来源期刊

Cirugia Y Cirujanos 医学-外科

CiteScore

0.90

自引率

20.00%

发文量

207

审稿时长

6-12 weeks

期刊介绍： Cirugía y Cirujanoses exponente del desarrollo académico, científico, médico, quirúrgico y tecnológico en materia de salud en México y en el ámbito internacional. Es una revista bimestral, open access, revisada por pares, que publica en español y en inglés (traducido sin coste para los autores) artículos científicos originales, casos clínicos, artículos de revisión de interés general y cartas al editor. Los artículos se seleccionan y publican siguiendo un riguroso análisis, de acuerdo con los estándares internacionalmente aceptados. Sus espacios están abiertos a los académicos, así como a todo miembro de la comunidad médica que manifieste interés por utilizar este foro para publicar sus trabajos.