South Clin Ist Euras. 2018; 29(4): 268-275 | DOI: 10.14744/scie.2018.37029

Gastrointestinal Cerrahi Geçirmiþ Kritik Hastalarda Erken Ýntraabdominal Enfeksiyonun Tanýsýnda C-Reaktif Protein ve Prokalsitoninin Rolü

Mustafa Altýnay, Surhan Çýnar, Mustafa Akker, Hacer Þebnem Türk
Saðlýk Bilimleri Üniversitesi, Þiþli Hamidiye Etfal Eðitim Ve Araþtýrma Hastanesi, Anestezioloji Ve Reanimasyon Kliniði, Ýstanbul

GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý gastrointestinal cerrahi hastalarýnýn intraabdominal infektif komplikasyonlarýnda CRP ve PCT'nin rolünü belirlemektir.
YÖNTEM ve GEREÇLER: Bu çalýþma prospektif, tek kör bir çalýþmadýr. Hastalar yoðun bakým ünitesine transfer edilen kritik gastrointestinal sistem cerrahisi hastalarýydý. Hastalarýn serum CRP ve PCT düzeyleri ameliyat sonrasý 1., 24., 48. ve 72. saatlerde ölçüldü. Ýntraabdominal infeksiyonlu hastalar kaydedildi.
BULGULAR: Çalýþmaya 49 hasta dahil edilmiþtir. Bu hastalarýn% 38'inde intraabdominal enfeksiyon geliþti ve mortalite oraný% 4 idi. Özellikle PCT düzeylerinin 48 ve 72. saatlerde istatistiksel olarak anlamlý olduðu görüldü. Duyarlýlýk ve özgüllük postoperatif 48. ve 72. saatlerde CRP düzeyinin sýrasýyla% 78.9 ve% 70 olduðu saptandý.PCT düzeyinin duyarlýlýðý ve özgüllüðü postoperatif 48. saatte sýrasýyla% 73.7 ve% 96.7 ve 72. saatte sýrasýyla% 84.2 ve% 90 idi.
TARTIÞMA ve SONUÇ: 48 ve 72. saatlerde artmýþ serum PCT ve CRP konsantrasyonlarý, intraabdominal enfeksiyonlarýn erken teþhisi için kritiktir. Postoperatif PCT konsantrasyonlarýnýn 48 ve 72. saatlerdeki prediktifliði, CRP'ye kýyasla enfektif komplikasyonlar açýsýndan daha yüksektir.

Anahtar Kelimeler: C reaktif Protein, Prokalsitonin, Ýntraabdominal enfeksiyon, Gastrointestinal Cerrahi

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The Role Of The C-Reactive Protein and Procalcitonin in The Early Diagnosis Of Intraabdominal Infection in Critical Patients With A History of Gastrointestinal Surgery

Mustafa Altýnay, Surhan Çýnar, Mustafa Akker, Hacer Þebnem Türk
Unýversýty Of Health Scýences, Þiþli Hamiye etfal education and research hospital, department of anestesiology and reanimation, istanbul, turkey

INTRODUCTION: The purpose of this study is to determine the roles of CRP and PCT in the intraabdominal infective complications of gastrointestinal surgery patients.
METHODS: This study is a prospective,single-blinded study.The subjects were critical gastrointestinal system surgery patients who had been transferred to the intensive care unit.The patients' serum CRP and PCT levels were measured in the 1st, 24th, 48th and 72nd hours after surgery.Those patients with intraabdominal infections were recorded.
RESULTS: The study includes 49 patients.Of these patients 38% developed intraabdominal infections and the mortality rate was 4%.It was observed that the PCT levels in particular were statistically very significant at the 48th and 72nd hours.The sensitivity and specificity of the CRP level at the postoperative 48th and 72nd hours were 78.9% and 70% respectively.The sensitivity and specificity of the PCT level were 73.7% and 96.7% respectively at the postoperative 48th hour, and 84.2% and 90% respectively at the 72nd hour.
DISCUSSION AND CONCLUSION: The elevated serum PCT and CRP concentrations at the 48- and 72-hour markers are critical for the early diagnosis of the intraabdominal infections.The predictivity of postoperative PCT concentrations at the 48th and 72nd hours is higher regarding infective complications compared to CRP.

Keywords: C-Reactive Protein, Procalcitonin, Intraabdominal Infection, Gastrointestinal Surgery

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