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Objective:To study serum procalcitonin (PCT), C-reactive protein (CRP) and platelet count (PLT) in evaluation of severity of acute cholangitis (AC).Methods:Ninety patients with AC who were treated at the General Surgery Department, Guangming Hospital, Liaocheng, Shandong Province from January 2016 to December 2018 entered into the observation group, while 60 patients with bile duct stones but without infection treated at the hospital during the study period entered into the control group. Using the " Guidelines for the Diagnosis and Treatment of Acute Biliary Tract Infections" , the study group of patient was further divided into the mild infection, moderate infection, and severe infection groups. The PCT, CRP and PLT levels of all the subjects were checked. Spearman correlation was used to analyze the relationship between PCT, CRP, PLT indexes with severity of infection. The receiver operating characteristic curve was used to analyze the sensitivity and specificity of PCT, CRP and PLT in the diagnosis of patients with different degrees of infection.Results:In the observation group, there were 46 males and 44 females with a Mean±SD age of (45.6±21.1) years. In the control group, there were 30 males and 30 females, with a Mean±SD age of (45.0±19.3) years. The levels of PLT in the observation group and the control group were (8.2±1.1) ng/ml and (0.4±0.1) ng/ml, respectively. The corresponding CRP were (92.7±21.1) mg/L and (6.1±1.0) mg/L, respectively. The observation group had higher levels than the control group. The PLT counts were (62.6±17.6)×10 9/L and (156.3±35.3)×10 9/L for the two groups, with the observation group having lower platelet count than the control group (both P<0.05). The severity of infection was positively correlated with blood PCT levels and CRP indicators ( r=0.427, r=0.584, all P<0.05), and negatively correlated with the PLT ( r=-0.429, P<0.05). The sensitivity and specificity of PCT using a cut-off value of 9.4 μg/L were 84.0% and 65.0%, respectively, which were higher than the CRP using a cut-off value of 145.7 mg/L. The sensitivity and specificity were 67.0% and 48.0%, respectively. When PLT using a cut-off value of 52.8×10 9/L, the sensitivity and specificity were 71.0% and 52.0%, respectively. Conclusions:Changes in serum PCT, CRP and PLT reflected the severity of infection in patients with AC; PCT had a higher sensitivity and specificity, and it can be used to guide treatment.
RESUMO
ObjectiveTo study the effect of a fast-track surgery (FTS) program on the clinical outcomes in cirrhotic patients with portal hypertension.Methods42 cirrhotic patients with portal hypertension were randomly allocated into the FTS group (n=21) and the conventional therapy control group (n=21).The postoperative time to first defecation,hospital stay,hospitalization cost,and postoperative complications were compared between the two groups.ResultsCompared with the control group,the postoperative time to first defecation was significantly shorter in the FTS group (P=0.0287).Furthermore,the postoperative hospital stay was significantly shorter in the FTS group than the control group (P=0.002).Additionally,hospitalization cost was significantly lower in the FTS group than the control group (P＜0.001).The postoperative complication was also significantly different between the two groups (7.15 ％ vs 21.5 ％,P=0.001).ConclusionA FTS program contributed to better postoperative rehabilitation in cirrhotic patients with portal hypertension.