江汉大学学报(自然科学版) ›› 2024, Vol. 52 ›› Issue (5): 62-70.doi: 10.16389/j.cnki.cn42-1737/n.2024.05.007

• 医学 • 上一篇    

降钙素原对结直肠手术后吻合口漏预测价值的 Meta 分析

李镇圻1 ,刘 佳2a ,李晓林2a ,张光福2a ,管云飞*2b ,和红阳2b   

  1. 1. 重庆医科大学 附属北碚医院胃肠与血管外科,重庆 400700;2. 大理大学 a. 临床医学院; b. 第一附属医院普外一科,云南 大理 671000
  • 发布日期:2024-10-24
  • 通讯作者: 管云飞
  • 作者简介:李镇圻(1995— ),男,硕士生,研究方向:普外科。
  • 基金资助:
    云 南 省 教 育 厅 科 研 基 金 项 目(2017ZDX013);大 理 大 学 第 一 附 属 医 院 学 科 建 设 骨 干 项 目 (DFYGG2022-13)

A Meta-analysis of the Predictive Value of Calcitoninogen for Anastomotic Fistula After Colorectal Surgery

LI Zhenqi,LIU Jia,LI Xiaolin,ZHANG Guangfu,GUAN Yunfei,HE Hongyang   

  1. 1. Department of Gastrointestinal and Vascular Surgery,Beibei Hospital Affiliated to Chongqing Medical University, Chongqing 400700,China;2. a. School of Clinical Medical;b. Department of General Surgery,the First Affiliated Hospital of Dali University,Dali University,Dali 671000,Yunnan,China
  • Published:2024-10-24
  • Contact: GUAN Yunfei

摘要: 目 的 运用 Meta 分析探究降钙素原(PCT)预测结直肠手术后吻合口漏(AL)的价值。 方 法 以“吻合口漏”、“吻合口瘘”、“降钙素原”等为关键词,检索 PubMed、知网、CBM 等八大数 据 库 中 有 关 降 钙 素 原 预 测 结 直 肠 手 术 后 吻 合 口 漏 的 文 献 ,并 对 符 合 纳 入 排 除 标 准 的 研 究 行 QUADAS-2 偏倚风险评价,采用 Review Manager 5.3 软件行风险评价可视化并进行筛选,决定 最后纳入 Meta 分析的文献,使用 Stata 14.0、Meta DiSc 1.4 软件 Meta 分析降钙素原对结直肠手术 后吻合口漏的诊断价值。结 果 以相应关键词检索出共 455 篇文献,归入文献 10 篇,进一步 Meta 分析提示纳入文献中术后第 5 天 PCT 预测结直肠手术后 AL 的合并灵敏度为 0. 85(95%CI (0. 76,0. 91)),合 并 特 异 度 为 0. 85(95%CI(0. 83,0. 87))。 合 并 AUC = 0. 914 9,Q 指 数 = 0. 847 5;合并诊断比值比 DOR 为 32. 89(95%CI(17. 44,62. 03))。结 论 结直肠术后第 5 天实 验室检查 PCT 以预测结直肠手术后吻合口漏具有重要临床价值。

关键词: 降钙素原, 吻合口漏, 结直肠手术, Meta 分析

Abstract: Objective To investigate the value of calcitoninogen (PCT) to predict anastomotic leakage (AL) after colorectal surgery using meta-analysis.Methods We searched literature about predicting the risk of anastomotic leakage after colorectal surgery with calcitoninogen in eight major databases,including PubMed,CNKI,and CBM,for the keywords ″ anastomotic leakage″ ,″ anastomotic fistula″ ,and ″ calcitoninogen″. The studies that met the inclusion and exclusion criteria were evaluated by QUADAS-2 risk of bias and visualized using Review Manager 5.3 software to determine the final literature for inclusion in the Meta-analysis,and Stata 14.0 and Meta DiSc 1.4 software were used to analyze the diagnostic value of calcitoninogen on anastomotic leakage after colorectal surgery.Results A total of 455 papers were searched with the corresponding keywords,and 10 papers were finally categorized. Meta-analysis suggested that the combined sensitivity of PCT on postoperative day 5 for predicting AL after colorectal surgery in the included literature was 0. 85(95%CI(0. 76,0. 91)),and the combined specificity was 0. 85(95%CI(0. 83, 0. 87)). The combined AUC = 0. 914 9 and Q-index = 0. 847 5; the combined diagnostic ratio DOR was 32. 89(95%CI(17. 44, 62. 03)).Conclusion PCT in the laboratory on the fifth postoperative day to predict AL after colorectal surgery has important clinical value.

Key words: calcitoninogen, anastomotic leakage, colorectal surgery, Meta-analysis

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