中性粒细胞与淋巴细胞比值与腹腔镜根治性右半结肠切除术后早期并发症的相关性研究  

The correlation between neutrophil to lymphocyte ratio and early complications after laparoscopic radical right hemicolectomy

作　　者：武群政 毛佳佳[1] 赵祥 王晓阳[1] WU Qunzheng;MAO Jiajia;ZHAO Xiang(Department of General Surgery,Qilu Hospital of Shandong University,Jinan 250012,China)

机构地区：[1]山东大学齐鲁医院普通外科,山东济南250012

出　　处：《腹腔镜外科杂志》2025年第1期28-33,共6页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜根治性右半结肠切除术患者中性粒细胞与淋巴细胞比值与术后早期并发症的相关性。方法:回顾分析2022年1月至2023年12月行腹腔镜根治性右半结肠切除术的126例患者的临床资料。根据是否出现术后早期并发症分为并发症组(n=31)与无并发症组(n=95)。对比分析两组患者一般资料及实验室检查等相关指标。采用单因素与多因素分析确定腹腔镜根治性右半结肠切除术后早期并发症的危险因素。绘制中性粒细胞与淋巴细胞比值的受试者工作特征曲线,确定最佳截断值并计算曲线下面积,评估对术后早期并发症的预测效能。结果:入组患者中31例(24.60%)发生术后早期并发症。单因素分析显示,并发症组与无并发症组的术后第1天、第3天降钙素原水平及术后第3天中性粒细胞与淋巴细胞比值差异有统计学意义(P<0.05)。多因素分析显示,术后第3天中性粒细胞与淋巴细胞比值是术后早期并发症的独立预测因素(OR=1.119,95%CI=1.019~1.229,P=0.019)。受试者工作特征曲线分析结果显示,临界值为7.1554,曲线下面积为0.640。结论:术后第3天中性粒细胞与淋巴细胞比值是腹腔镜根治性右半结肠切除术后早期并发症的独立预测因素,具有临床指导意义。Objective:To explore the correlation between neutrophil to lymphocyte ratio and early postoperative complications in patients undergoing laparoscopic radical right hemicolectomy.Methods:A retrospective analysis was conducted on clinical data of 126 patients who underwent laparoscopic radical right hemicolectomy from Jan.2022 to Dec.2023.Patients were grouped according to whether there were early postoperative complications,31 cases were in the complication group,and 95 cases were in the no-complication group.The general data and laboratory examination results of the two groups were compared and analyzed.Univariate and multivariate analyses were used to determine the risk factors for early postoperative complications after laparoscopic radical right hemicolectomy.The receiver operating characteristic curve of neutrophil to lymphocyte ratio was plotted to determine the optimal cutoff value and calculate the area under the curve,and the predictive efficacy for early postoperative complications was evaluated.Results:A total of 31 patients(24.60%)in the study group experienced early postoperative complications.Univariate analysis showed that there was statistically significant difference between complication group and no-complication group in the levels of procalcitonin on postoperative day 1 and 3,as well as the neutrophil to lymphocyte ratio value on postoperative day 3(P<0.05).Multivariate analysis showed that the neutrophil to lymphocyte ratio value on postoperative day 3 was an independent predictor of early postoperative complications(OR=1.119,95%CI=1.019~1.229,P=0.019).The receiver operating characteristic curve analysis showed that the optimal cut-off value was 7.1554 and the area under the curve was 0.640.Conclusions:The neutrophil to lymphocyte ratio on postoperative day 3 is an independent predictor of early complications after laparoscopic radical right hemicolectomy,which has certain clinical guidance significance.

关 键 词：结肠肿瘤 右半结肠癌根治术 腹腔镜检查 中性粒细胞与淋巴细胞比值 手术后并发症 

分 类 号：R735.35[医药卫生—肿瘤]