C－反应蛋白在腹腔镜与开腹结直肠癌术后吻合口瘘患者中的水平变化与临床意义

摘要

Objective To investigate the changes and clinical significances of C-reaction protein (CRP)level in patients with postop-erative anastomotic leak after colorectal cancer surgeries.Methods 392 cases were retrospectively analyzed,which were divided into anastomotic leakage after laparoscopic radical resection group (28 cases),non-anastomotic leakage after laparoscopic radical resection group (186 cases),anastomotic leakage after laparotomy group (24 cases)and non-anastomotic leakage after laparotomy group (161 cases).Blood CRP level was compared postoperatively on day 1,2,3,5 and 7.Results CRP level in anastomotic leakage after laparot-omy group was higher than that in anastomotic leakage after laparoscopic radical resection group (P<0.05)on day 1,3 and 5.CRP level increased starting from day 1 in both anastomotic leakage groups.Compared with non-anastomotic leakage group,CRP level sig-nificantly increased in the corresponding anastomotic leakage group from day 2 (P<0.05 ).Conclusion Persistent elevation of CRP was a cause of postoperative anastomotic leak after colorectal cancer surgeries.Postoperative monitoring CRP may be more important.%目的：评价结直肠癌术后吻合口瘘患者血液中C－反应蛋白（CRP）水平变化与临床意义。方法392例结直肠癌患者，其中行腹腔镜结直肠癌根治术214例，行开腹结直肠癌根治术185例，据术后吻合口瘘发生情况分为腹腔镜吻合口瘘组（28例）、腹腔镜非吻合口瘘组（186例）、开腹吻合口瘘组（24例）与开腹非吻合口瘘组（161例），动态监测并对比分析各组患者术前与术后不同时间点（术后第1、2、3、5、7天）血液中CRP水平变化差异。结果术后第1、2、3、5天开腹吻合口瘘组CRP水平均明显高于腹腔镜吻合口瘘组（P＜0．05）；术后腹腔镜吻合口瘘组与开腹吻合口瘘组CRP水平均在术后第1天即开始上升，且均在术后第2天显著高于对应非吻合口瘘组（P＜0．05）。结论 CRP水平持续性升高为结直肠癌术后发生吻合口瘘的危险性因素，无论对于腹腔镜或开腹结直肠癌手术，动态监测患者血液中CRP值对早期发现吻合口瘘均具有一定预测价值。