炎性指标在阑尾炎穿孔诊断中的价值研究

发布时间：2018-03-06 18:28

本文选题：阑尾炎　切入点：阑尾炎穿孔　出处：《中国全科医学》2017年17期 　论文类型：期刊论文

【摘要】：目的探讨C反应蛋白(CRP)及白细胞计数、中性粒细胞分数等炎性指标诊断阑尾炎穿孔的价值。方法选取2012—2015年在宁波大学医学院附属鄞州医院术前诊断为急性阑尾炎(含慢性阑尾炎急性发作)行阑尾手术(含腹腔镜阑尾切除术)患者862例。根据阑尾炎是否穿孔分为穿孔组(146例)和未穿孔组(716例)。收集患者术前同一时间点CRP、白细胞计数、中性粒细胞分数,绘制受试者工作特征(ROC)曲线,判断其诊断阑尾炎穿孔的价值。结果穿孔组和未穿孔组白细胞计数、中性粒细胞分数比较,差异均无统计学意义(P0.05)。穿孔组CRP水平高于未穿孔组(P0.05)。CRP50 mg/L时,诊断阑尾炎穿孔的灵敏度是78.8%,特异度是90.9%。穿孔组与未穿孔组老年人和中青年人CRP水平比较,差异均有统计学意义(P0.05)。CRP25 mg/L时,诊断老年人阑尾炎穿孔的灵敏度是82.4%,特异度是81.0%。CRP50 mg/L时,诊断中青年人阑尾炎穿孔的灵敏度是80.2%,特异度是89.7%。结论白细胞计数、中性粒细胞分数在术前无法准确诊断阑尾炎是否穿孔,但CRP可作为诊断急性阑尾炎是否穿孔的指标,并且诊断价值在中青年患者中较老年患者强。
[Abstract]:Objective to study the C-reactive protein (CRP) and white blood cell count (WBC). Value of inflammatory markers such as neutrophil fraction in the diagnosis of appendicitis perforation methods appendicitis was diagnosed as acute appendicitis (including acute attack of chronic appendicitis) from 2012 to 2015 at Yinzhou Hospital affiliated to Ningbo University Medical College. 862 patients (including laparoscopic appendectomy) were divided into perforation group (n = 146) and non-perforation group (n = 716) according to whether the appendicitis was perforated. Results the neutrophil fraction (neutrophil fraction) curve was drawn to determine the diagnostic value of appendicitis perforation. Results the leukocyte count and neutrophil fraction were compared between perforation group and unperforated group. When the CRP level in perforation group was higher than that in unperforated group, the sensitivity of diagnosis of appendicitis perforation was 78.8, and the specificity was 90.9.The CRP level in the perforation group was higher than that in the elderly and middle and young people without perforation. The sensitivity of diagnosis of appendicitis perforation in the elderly was 82.4, the specificity was 81.0. CRP50 mg/L, the sensitivity of young patients with appendicitis perforation was 80.2 and the specificity was 89.70.Conclusion White blood cell count is the most important factor in the diagnosis of appendicitis perforation. Neutrophil fraction could not accurately diagnose perforation of appendicitis before operation, but CRP could be used as an index to diagnose perforation of acute appendicitis, and the diagnostic value of neutrophil fraction was stronger in young and middle-aged patients than in elderly patients.
【作者单位】：宁波大学医学院附属鄞州医院普外科;
【分类号】：R656.8

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