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| C反应蛋白和降钙素原腹腔镜袖状胃切除术后早期的病态肥胖患者感染并发症的标记，在手术后一个增强的恢复计划 C-Reactive Protein and Procalcitonin as Early Markers of Septic Complications after Laparoscopic Sleeve Gastrectomy in Morbidly Obese Patients Within an Enhanced Recovery After Surgery Program
摘要 BACKGROUND: 背景： The performance of most bariatric procedures within an Enhanced Recovery After Surgery (ERAS) programs has resulted in considerable advantages, including a reduction in the length of hospital stay to 2 to 3 days. However, some postoperative complications can appear after the patient has been discharged. The aim of this study was to investigate the efficacy of various acute-phase parameters determined 24 and 48 hours after laparoscopic sleeve gastrectomy (LSG) as bariatric procedure, for predicting septic complications, such a surgical site infection (SSI), in the postoperative course. 大多数减肥手术在提高手术后的恢复效果(ERAS)计划已经造成了相当大的优势，包括住院时间的减少到2至3天。然而，一些术后并发症出现后，病人已出院。本研究的目的是探讨不同急性期的参数确定在24小时和48小时后腹腔镜袖状胃切除术的疗效（LSG）为减肥过程，预测感染性并发症，如外科手术部位感染（SSI），在术后的过程。 STUDY DESIGN: 研究设计： A prospective study of 115 morbidly obese patients who underwent LSG within an ERAS program between 2012 and 2015 was conducted. Blood analysis was performed 24 and 48 hours after surgery. Acute-phase parameters (C-reactive protein [CRP], procalcitonin, and fibrinogen) and WBC count were investigated. 一个115的病态肥胖患者接受LSG的前瞻性研究，安排计划LSG在2012和2015之间进行。术后24小时和48小时进行血液分析。急性期参数（C-反应蛋白[ CRP]，降钙素和纤维蛋白原）及白细胞计数进行了调查。 RESULTS: 结果: Septic complications were observed in 13 patients (11.3%). Using receiver operating characteristic analysis at 24 hours postoperatively, a cutoff level of CRP at 70 mg/L achieved 85% sensitivity and 90% specificity for predicting SSI, and a cutoff level of procalcitonin at 0.2 ng/mL achieved 70% sensitivity and 90% specificity. At 48 hours postoperatively, a cutoff level of CRP at 150 mg/L and procalcitonin at 0.95 ng/mL achieved 100% sensitivity and 100% specificity for predicting SSI. 在13例患者中进行感染性并发症观察（11.3%）。术后24小时内使用受试者的术后特征分析，截止CRP水平在70毫克/升的预测SSI达到85%的敏感性和90%的特异性，和血清降钙素原截止水平为0.2毫微克/毫升达到70%的敏感性和90%的特异性。在术后48小时，截止CRP水平在150毫克/升、降钙素原在0.95 ng/ml预测SSI达到100%的敏感性和100%的特异性。 CONCLUSIONS: 结论： The use of CRP and procalcitonin in the first day and especially in the second day postoperative can predict septic complications after LSG. This is most useful for patients within an ERAS program who will be discharged early. 使用CRP和降钙素在第一天，特别是在第二天术后感染并发症后可以预测LSG。这是最有用的，患者在ERAS安排计划内决定谁将提前出院。 原文： |
