直肠癌术后吻合口漏患者手术后血液中白蛋白、C-反应蛋白及前白蛋白的水平变化及临床意义

目的 探讨直肠癌术后发生吻合口漏患的者手术后血液中白蛋白(Albumin,ALB)、C-反应蛋白(C-reactive protein,CRP)及前白蛋白(PreAlbumin,PA)水平的变化及临床意义.方法 回顾性分析从2009年1月～2010年12月在桂林医学院附属医院胃肠外科行直肠癌保肛手术治疗的患者193例.将研究对象分为吻合口漏组及非吻合口漏组,动态检测两组手术后第1、3、S和7天血液中ALB、CRP及PA水平变化并进行比较.结果 吻合口漏组术后ALB、PA值呈下降趋势,CRP值呈升高趋势,非吻合口漏组术后ALB、PA值呈升高趋势,CRP值呈下降趋势.术后第5天,两组的ALB值比较,差异有显著性,术后第3天,两组CRP值比较,差异有显著性,术后第1天,两组的PA值比较,差异有显著性.结论 CRP水平的持续性升高,PA和ALB水平的下降是直肠癌术后发生吻合口漏的危险因素,CRP和PA水平的变化较ALB更灵敏,术后动态监测血液中CRP和PA水平的变化较ALB更有意义.

Changes and clinical significances of albumin,C-reactive protein and prealbumin levels in the blood of patients with anastomotic leak after colorectal cancer surgeries

【Objective】 To discuss the changes and significances of albumin(ALB),C-reactive protein(CRP) and prealbumin(PA) levels in the blood of patients with anastomotic leak after colorectal cancer surgeries.【Methods】 Data of 193 cases of anus-saving surgeries in rectal cancer patients in the Dept.of Gastrointestinal Surgery,the affiliated Hospital of Guilin Medical University from Jan.of 2009 to Dec.of 2010 were retrospectively analyzed.The subjects were divided into anastomotic leakage group and non-anastomotic leakage group.ALB,CRP,and PA level changes in the blood of both groups underwent dynamic detection and comparison on the 1st,3rd,5th and 7th day after operation.【Results】 ALB and PA level in the blood showed a downtrend while CRP was with a tendency to increase in the anastomotic leakage group after operation,and vice versa in the non-anastomotic leakage group.On the 5th day after surgeries,ALB value in both groups was of statistical difference,on the 3rd day after surgeries,CRP value in both groups was of statistical difference,and on the 1st day after operation,PA value in both groups was significantly different.【Conclusion】 The continuous increase of CRP level and the decrease of PA and ALB levels are one of the causes of anastomotic leakage of postoperation of rectal cancer.The changes of CRP and PA levels in the blood are more sensitive than ALB,so the postoperative dynamic monitoring of them is more important than the monitoring of ALB.