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中华普外科手术学杂志(电子版) ›› 2020, Vol. 14 ›› Issue (05) : 534 -537. doi: 10.3877/cma.j.issn.1674-3946.2020.05.028

所属专题: 文献

综述

降钙素原在吻合口漏中的应用现状
丁杰1, 康星1, 陈虹2, 管文贤2, 乔彤3,()   
  1. 1. 211166 南京医科大学鼓楼临床医学院普通外科;210008 南京大学医学院附属鼓楼医院普通外科
    2. 210008 南京大学医学院附属鼓楼医院普通外科
    3. 210008 南京大学医学院附属鼓楼医院血管外科
  • 收稿日期:2020-03-15 出版日期:2020-10-26
  • 通信作者: 乔彤

Application status of procalcitonin in anastomotic leakage

Jie Ding1, Xing Kang1, Hong Chen2, Wenxian Guan2, Tong Qiao3,()   

  1. 1. Department of General Surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China; Department of General Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
    2. Department of General Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
    3. Department of Vascular surgery, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing 210008, China
  • Received:2020-03-15 Published:2020-10-26
  • Corresponding author: Tong Qiao
  • About author:
    Corresponding author: Qiao Tong, Email:
    Ding Jie and Kang Xing contributed equally to this article
  • Supported by:
    National Natural Science Foundation of China(81870348); Jiangsu’s Six Talents Summit Project(WSN-134)
引用本文:

丁杰, 康星, 陈虹, 管文贤, 乔彤. 降钙素原在吻合口漏中的应用现状[J]. 中华普外科手术学杂志(电子版), 2020, 14(05): 534-537.

Jie Ding, Xing Kang, Hong Chen, Wenxian Guan, Tong Qiao. Application status of procalcitonin in anastomotic leakage[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2020, 14(05): 534-537.

吻合口漏(AL)是食管癌及结直肠癌手术后常见的严重并发症,也是主要的致死原因,受多种危险因素影响。近年来外科手术技术的不断提高和围术期管理的经验积累,尤其是吻合器的临床应用,使得AL的发生率和死亡率已有所降低,不过仍是外科医生所面临的最为棘手问题之一。因此,早期发现或预测AL就显得尤为重要,进而可提早干预,避免或减轻AL带来的临床症状及不良后果,提高患者生存质量。然而,目前关于预测AL的方法并未有严格的标准,主要集中在术后生物标记物的检测,本文旨在对降钙素原(PCT)在预测AL中的应用现状进行综述。

Anastomotic leakage (AL) of operation for esophageal cancer and colorectal cancer is one of the most common serious complication, it is the leading cause of death, and influenced by a number of factors. In recent years, with the improvement of surgical technique and the accumulation of experience of perioperative management, especially the clinical application of anastomosis instrument, the morbidity and mortality of AL has been reduced, but AL is still one of the most intractable problems faced by the surgeon. Therefore, early detection or prediction of AL is particularly important, so that early intervention can avoid or reduce the clinical symptoms and adverse consequences brought by AL, and improve the quality of life of patients. However, there is no strict standard for predicting AL at present, which mainly focuses on the detection of postoperative biomarkers. This paper aims to review the application of procalcitonin (PCT) in the prediction of AL.

[1]
本刊编辑部.吻合口漏与吻合口瘘[J]. 中华胃肠外科杂志,2019,22(7):696.
[2]
沈荐,李敏哲,杜燕夫,等.腹腔镜直肠癌低位前切除术后吻合口漏的危险因素分析[J].中国微创外科杂志,2017,17(10):873-876.
[3]
李思源,赵鹏,李洪波,等.结直肠癌术后吻合口瘘的危险因素分析[J].中国现代普通外科进展,2015,18(2):163-164.
[4]
Huang JX, Zhou Y, Wang CH, et al. Logistic regression analysis of the risk factors of anastomotic fistula after radical resection of esophageal-cardiac cancer[J]. Thorac Cancer,2017,8(6):666-671.
[5]
Karstens KF,Stüben BO, Ghadban T,et al.The decrease of BMI and albumin levels influences the rate of anastomotic leaks in patients following reconstruction after emergency diverting esophagectomy[J]. Esophagus,2020,17(2):183-189.
[6]
Shimura T,Toiyama Y,Hiro J,et al. Monitoring perioperative serum albumin can identify anastomotic leakage in colorectal cancer patients with curative intent[J]. Asian J Surg,2018,41(1):30-38.
[7]
Kassis ES, Kosinski AS, Ross PJr,et al. Predictors of anastomotic leak after esophagectomy: an analysis of the society of thoracic surgeons general thoracic database[J]. Ann Thorac Surg,2013,96(6):1919-2196.
[8]
Lopez-Kostner F, Lavery IC, Hool GR, et al. Total mesorectal excision is not necessary for cancers of the upper rectum[J]. Surgery,1998,124(4):612-617.
[9]
Vignali A, Fazio VW, Lavery IC, et al. Factors associated with the occurrence of leaks in stapled rectal anastomoses: a review of 1,014 patients[J]. J Am Coll Surg,1997,185(2):105-113.
[10]
刘京新,于红卫,赵玉歧,等.膈肌剧烈运动对弓下胃食管吻合口张力影响分析[J].临床医学,2003,23(10):27-28.
[11]
Kim CH, Joo JK, Kim HR,et al. The incidence and risk of early postoperative small bowel obstruction after laparoscopic resection for colorectal cancer[J]. J Laparoendosc Adv Surg Tech A,2014,24(8):543-549.
[12]
Yang L, Huang XE, Zhou JN. Risk assessment on anastomotic leakage after rectal cancer surgery: an analysis of 753 patients[J]. Asian Pac J Cancer Prev,2013,14(7):4447-4453.
[13]
王锡山.直肠癌保肛系列问题探讨[J].实用肿瘤学杂志,2006,20(6):480-483.
[14]
Urschel JD. Esophagogastrostomy anastomotic leaks complicating esophagectomy: a review[J]. Am J Surg,1995,169(6):634-640.
[15]
屠金金,程勇.直肠癌术后吻合口瘘原因分析及防治现状[J].中国普通外科杂志,2010,19(4):422-425.
[16]
傅传刚,郝立强.低位直肠癌保肛术后吻合口漏与狭窄原因及治疗[J].中国实用外科杂志,2014,34(9):851-854.
[17]
Rahbari NN, Weitz J, Hohenberger W, et al. Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer[J]. Surgery,2010,147(3):339-351.
[18]
Meyer ZC, Schreinemakers JMJ, de Waal RAL,et al. Searching for predictors of surgical complications in critically ill surgery patients in the intensive care unit: a review[J]. Surg Today,2015,45(9):1091-1101.
[19]
崔宇,李波,陈进.血清降钙素原对肝胆手术后患者腹腔感染的预测效果分析[J].中华医院感染学杂志,2019,29(14):2154-2157.
[20]
王郝,崔娜,牛芳,等.降钙素原对心脏外科术后重症患者感染的早期预测价值[J].中华危重病急救医学,2017,29(10):897-901.
[21]
徐益萍,骆方军,郑军,等.重症急性胰腺炎患者血清降钙素原与C-反应蛋白测定的临床价值[J].中华医院感染学杂志,2017,27(5):1089-1092.
[22]
李广洲,朱宗文,王水平,等.降钙素原对胰十二指肠切除术后腹腔感染早期的预测价值[J].中华胰腺病杂志,2018,18(5):313-317.
[23]
左婷婷,郑荣寿,曾红梅,等.中国食管癌发病状况与趋势分析[J].中华肿瘤杂志,2016,38(9):703-708.
[24]
本刊编辑部.《邵令方食管外科学》即将出版[J/CD].食管外科电子杂志,2014,2(1):77.
[25]
王艳霞,王玉艳.三项指标检测对食管癌术后早期吻合口瘘的诊断价值[J].检验医学与临床,2017,14(19):2882-2884.
[26]
郝曙光,刘平,侯夏宝,等.血清降钙素原、C反应蛋白联合白蛋白预测食管癌术后早期吻合口瘘的应用价值[J].中华实验外科杂志,2016,33(3):791-793.
[27]
郭海龙.血清PCT、CRP和ALB对食管癌术后早期吻合口瘘的诊断效果[J].中国实用医刊,2017,44(3):34-36.
[28]
张胜,孔敏,崔可,等.降钙素原对食管癌根治术后吻合口瘘早期诊断的意义[J].中华全科医学,2015,13(4):526-528,682.
[29]
Li H, Wang DF, Wei WX, et al. The Predictive Value of Coefficient of PCT x BG for Anastomotic Leak in Esophageal Carcinoma Patients With ARDS After Esophagectomy[J]. J Intensive Care Med,2019,34(7):572-577.
[30]
Asti E, Bonitta G, Melloni M, et al. Utility of C-reactive protein as predictive biomarker of anastomotic leak after minimally invasive esophagectomy[J]. Observational Study,2018,403(2):235-244.
[31]
刘秋华,张伯,涂建成,等.双器械吻合联合全直肠系膜切除Dixon保肛手术治疗直肠癌的临床效果观察[J].中国现代医学杂志,2016,26(10):99-102.
[32]
秦敬.腹腔镜低位直肠癌保肛术后吻合口瘘的危险因素分析及预防对策[J].临床外科杂志,2017,25(7):531-533.
[33]
徐谊,赵晓牧,孙武青,等.直肠癌低位前切除术后吻合口瘘发生相关因素分析[J].首都医科大学学报,2017,38(5):727-732.
[34]
Goense L, van Rossum PSN, Ruurda JP, et al. Radiation to the Gastric Fundus Increases the Risk of Anastomotic Leakage After Esophagectomy[J]. Ann Thorac Surg,2016,102(6):1798-1804.
[35]
姚奇,何兰珍,刘贤明,等.腹腔镜Dixon直肠癌术后动态监测腹腔引流液中降钙素原、CRP水平对吻合口瘘的预测价值[J].新医学,2019, 50(11):850-854.
[36]
王金光,黄峰平,陶辉,等.淋巴细胞比值联合降钙素原对早期诊断直肠癌术后吻合口瘘的临床意义[J].浙江中西医结合杂志,2019,29(8):641-643.
[37]
胡侃,张裕桂,朱融慧,等.降钙素原和C反应蛋白检测对结直肠癌吻合口瘘早期诊断的价值分析[J].实验与检验医学,2019,37(3):433-434,443.
[38]
张盟,金洪永,樊奇浩,等.腹腔镜结直肠癌患者术后血液中C反应蛋白、血清降钙素原结合血清白蛋白预测早期吻合口瘘的临床价值[J].中国实验诊断学,2019,23(2):211-215.
[39]
吴国刚,刘兆润,冷梅,等.降钙素原与C反应蛋白在预测结直肠癌手术后吻合口瘘的临床价值[J/CD]. 中华普通外科学文献(电子版),2018,12(4):228-232.
[40]
Garcia-Granero A, Frasson M, Flor-Lorente B, et al. Procalcitonin and C-reactive protein as early predictors of anastomotic leak in colorectal surgery: a prospective observational study[J]. Dis Colon Rectum,2013,56(4):475-483.
[41]
Munoz JL, Alvarez MO, Cuquerella V, et al. Procalcitonin and C-reactive protein as early markers of anastomotic leak after laparoscopic colorectal surgery within an enhanced recovery after surgery (ERAS) program[J]. Surg Endosc,2018,32(9):4003-4010.
[42]
Smith SR, Pockney P, Holmes R, et al. Biomarkers and anastomotic leakage in colorectal surgery: C-reactive protein trajectory is the gold standard[J] ANZ J Surg,2018,88(5):440-444.
[43]
Zawadzki M, Czarnecki R, Rzaca M, et al. C-reactive protein and procalcitonin predict anastomotic leaks following colorectal cancer resections - a prospective study[J]. Wideochir Inne Tech Maloinwazyjne,2016,10(4):567-573.
[44]
Giaccaglia V, Salvi PF, Cunsolo GV, et al. Procalcitonin, as an early biomarker of colorectal anastomotic leak, facilitates enhanced recovery after surgery[J]. J Crit Care,2014,29(4):528-532.
[45]
Su'a BU, Mikaere HL, Rahiri JL, et al. Systematic review of the role of biomarkers in diagnosing anastomotic leakage following colorectal surgery[J]. Br J Surg,2017,104(5):503-512.
[46]
McDermott FD, Heeney A, Kelly ME, et al. Systematic review of preoperative, intraoperative and postoperative risk factors for colorectal anastomotic leaks[J]. Br J Surg,2015,102(5):462-479.
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