降钙素原对结直肠手术后吻合口漏预测价值的Meta分析  

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

作　　者：李镇圻 刘佳 李晓林 张光福 管云飞 和红阳 LI Zhenqi;LIU Jia;LI Xiaolin;ZHANG Guangfu;GUAN Yunfei;HE Hongyang(Department of Gastrointestinal and Vascular Surgery,Beibei Hospital Affiliated to Chongqing Medical University,Chongqing 400700,China;School of Clinical Medical,the First Affiliated Hospital of Dali University,Dali University,Dali 671000,Yunnan,China;Department of General Surgery,the First Affiliated Hospital of Dali University,Dali University,Dali 671000,Yunnan,China)

机构地区：[1]重庆医科大学附属北碚医院胃肠与血管外科,重庆400700 [2]大理大学临床医学院,云南大理671000 [3]大理大学第一附属医院普外一科,云南大理671000

出　　处：《江汉大学学报（自然科学版）》2024年第5期62-70,共9页Journal of Jianghan University：Natural Science Edition

基　　金：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)。

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=0.9149,Q指数=0.8475;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。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=0.9149 and Q-index=0.8475;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.

关 键 词：降钙素原 吻合口漏 结直肠手术 META分析 

分 类 号：R656.210.5[医药卫生—外科学]