PCT联合腹腔引流液淀粉酶测定在结直肠癌术后肠瘘诊断及预后评估的意义研究

doi:10.3969/j.issn.1009-976X.2025.03.003

摘要/Abstract

摘要： 目的分析血清降钙素原（PCT）联合腹腔引流液淀粉酶测定在结直肠癌术后肠瘘早期诊断及预后评估中的应用价值。方法选择广东省农垦中心医院2023年3月至2024年10月期间因结直肠癌进行手术治疗的80例患者,术后放置腹腔引流管,并在术后第1、3、5、7 d检测血清PCT、腹腔引流液淀粉酶水平,根据患者有无肠瘘分为肠瘘组、非肠瘘组,进行队列观察研究,对比分析两组血清PCT、腹腔引流液淀粉酶水平。结果术后不同时间段,肠瘘组与非肠瘘组的血清PCT、腹腔引流液淀粉酶水平比较差异显著（P<0.05）;ROC曲线分析发现,血清PCT、腹腔引流液淀粉酶联合诊断的AUC、灵敏度相对较高;术后第1、3、5、7 d,微瘘组、非微瘘组的血清PCT比较存在显著差异（P<0.05）;ROC曲线分析发现,血清PCT预测结直肠癌术后肠瘘预后情况的AUC为0.907,灵敏度为86.67%。结论腹腔引流液淀粉酶与血清PCT联合检测能提升结直肠癌术后肠瘘早期诊断效能,且血清PCT的变化可用于评估患者的预后。

关键词: 降钙素原, 腹腔引流液, 淀粉酶, 结直肠癌, 肠瘘

Abstract: Objective To analyze the application value of serum procalcitonin（PCT） combined with amylase measurement of peritoneal drainage fluid in the early diagnosis and prognosis evaluation of intestinal fistula after colorectal cancer surgery. Methods Patients who underwent surgical treatment for colorectal cancer at the hospital from March 2023 to October 2024 were selected for the study. Peritoneal drainage tubes were inserted post-operation, and serum PCT and amylase levels in the peritoneal drainage fluid were measured on the 1st, 3rd, 5th, and 7th days post-surgery. The patients were categorized into the intestinal fistula group and the non-intestinal fistula group based on the presence of an intestinal fistula, and a cohort observational study was conducted to compare and analyze the serum PCT and amylase levels in the peritoneal drainage fluid between the two groups. Results There were significant differences （P<0.05） in serum PCT and amylase levels in peritoneal drainage fluid between the intestinal fistula group and the non-intestinal fistula group at different postoperative time periods. ROC curve analysis revealed that the AUC and sensitivity of the combined diagnosis of serum PCT and peritoneal drainage amylase were relatively high. There were significant differences （P<0.05） in serum PCT levels between the micro-fistula group and the non-micro-fistula group on postoperative days 1, 3, 5, and 7. ROC curve analysis revealed that serum PCT had an AUC of 0.907 and a sensitivity of 86.67% for predicting the prognosis of postoperative intestinal fistula in colorectal cancer. Conclusion The combined detection of amylase in peritoneal drainage fluid and serum PCT can improve the early diagnostic efficiency of postoperative intestinal fistula in colorectal cancer, and changes in serum PCT levels can be used to evaluate the prognosis of patients.

Key words: procalcitonin, peritoneal drainage fluid, amylase, colorectal cancer, intestinal fistula

中图分类号:

林良学, 邓海梅, 蔡海晶, 庞绍春, 邓志安, 李奕廷, 王冠, 吴国忠. PCT联合腹腔引流液淀粉酶测定在结直肠癌术后肠瘘诊断及预后评估的意义研究[J]. 岭南现代临床外科, 2025, 25(03): 162-167.

LIN Liang-xue, DENG Hai-mei, CAI Hai-jing, PANG Shao-chun, DENG Zhi-an, LI Yi-ting, WANG Guan, WU Guo-zhong. Study on the significance of PCT combined with amylase measurement of peritoneal drainage fluid in the early diagnosis and prognosis evaluation of intestinal fistula after colorectal cancer surgery[J]. Lingnan Modern Clinics In Surgery, 2025, 25(03): 162-167.

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