直肠癌术后吻合口瘘患者CRP、A1b、PA水平的变化及意义

目的分析直肠癌术后吻合口瘘患者血液中C反应蛋白（C—reactiveprotein，CRP）值、白蛋白（albumin，Alb）值、前白蛋白（prealbumin，PA）值的变化及临床意义。方法根据吻合口痿发生情况，将151例直肠癌保肛手术患者分成吻合口瘘组（20例）合对照组（131例），比较并分析术后第1、3、5、7天两组患者血液中CRP值、Alb值、PA值。结果术后，吻合口瘘组患者CRP值呈上升趋势，Alb值、PA值呈下降趋势，对照组CRP值呈下降趋势，Alb值、PA值呈上升趋势。术后第1天，两组CRP值差异无统计学意义（P〉0．05）；术后第3、5、7天，两组CRP值差异有统计学意义（P〈0．05）。术后第1、3天，两组Alb值差异无统计学意义（P〉0．05）；术后第5、7天，两组Alb值差异有统计学意义（P〈0．05）；术后第1、3、5、7天，两组PA值差异均有统计学意义（P〈0．05）。结论直肠癌术后动态监测患者血液中CRP值、Alb值、PA值有助于早期发现吻合口瘘。

Blood C-reactive protein,albumin anastomotic leak after and prealbumin levels in patients with colorectal cancer surgery

Objective To investigate the blood levels of C-reactive protein （ CRP）, albumin （ ALB ） and prealbumin （PA） in patients with anastomotic leak after colorectal cancer surgery. Methods One hundred and fifty-one colorectal cancer patients with anus-saving surgery were included in the study, including 20 cases with anastomotic leakage and 131 cases without anastomotic leakage. CRP, ALB and PA levels in the blood were measured at dl, 3, 5 and 7 after operation in both groups. Results There was a tendency of increasing in CRP levels and decreasing in ALB and PA levels in anastomotic leakage group after operation, while CRP were decreasing and ALB and PA levels were increasing in non-leakage group. There were significance differences in CRP levels at d3, 5th and 7, ALB levels at d5 and 7, PA at dl, 3, 5 and 7 after operation between two groups （ all P 〈 0. 05 ）. Conclusion Postoperative monitoring blood CRP, ALB, and PA levels in colorectal cancer patients may be used as early indicator of anastomotic leak after operation.