急性阑尾炎患者穿孔的发病率及其危险因素研究

发布时间：2018-03-24 17:01

本文选题：阑尾炎　切入点：穿孔　出处：《中国全科医学》2015年23期

【摘要】：目的探索急性阑尾炎患者穿孔的发病率及其相关危险因素。方法选取2011—2014年明光市人民医院普外科手术治疗的急性阑尾炎患者330例,依据术后病理诊断结果将患者分为穿孔组和无穿孔组。记录患者病程、术前住院时间、发病至手术时间、术前最高体温、术前脉搏、术前呼吸频率、术前血压、术中所见、术后病理检查结果;记录实验室血常规、尿常规的检测结果,记录项目:白细胞计数(WBC)、中性粒细胞分数(NCP)、淋巴细胞分数(LCP)、淋巴细胞绝对数(LAC)、红细胞计数(RBC)、血红蛋白(HGB)、血细胞比容(HCT)、尿常规全部项目。采用Logistic回归分析影响急性阑尾炎患者发生穿孔的危险因素。结果 330例患者中穿孔69例,发病率为20.9%。男性穿孔发病率为23.6%,女性穿孔发病率为17.6%,两者比较,差异无统计学意义(χ2=1.812,P=0.178)。≤44岁、45~59岁、≥60岁者穿孔发病率分别为22.8%、15.0%、17.2%,3者比较,差异无统计学意义(χ2=2.036,P=0.361)。穿孔组与无穿孔组术前最高体温、术前脉搏、术前呼吸频率、WBC、NCP、LCP、LAC、尿常规异常比较,差异均有统计学意义(P0.05)。多因素Logistic回归分析结果显示,术前最高体温、术前脉搏、LCP是急性阑尾炎发生穿孔的危险因素(P0.05)。模型经Hosmer-Lemeshow检验(χ2=0.405,P=0.939),预测正确率为79.1%。结论住院患者急性阑尾炎穿孔发病率约为1/5,术前最高体温、术前脉搏和LCP是影响阑尾炎患者发生穿孔的因素,其中LCP作为与穿孔密切关联的新因素纳入Logistic回归模型,有助于穿孔预测。
[Abstract]:Objective to investigate the incidence and risk factors of perforation in patients with acute appendicitis. Methods 330 patients with acute appendicitis treated by general surgery in Mingguang people's Hospital from 2011 to 2014 were selected. The patients were divided into perforation group and non-perforated group according to the results of pathological diagnosis after operation. The course of disease, the time of hospitalization before operation, the time from onset to operation, the highest temperature before operation, the pulse before operation, the frequency of respiration before operation, the blood pressure before operation, and the intraoperative findings were recorded. The results of pathological examination, laboratory blood routine and urine routine examination were recorded. Record items: WBC count, neutrophil fraction, neutrophil fraction, lymphocyte fraction, lymphocyte absolute count, red blood cell count, hemoglobin, hematocrit, urine routine. Logistic regression analysis was used to influence acute. The risk factors of perforation in appendicitis patients. The incidence of perforation was 23.6in males and 17.6in females. There was no significant difference between the two groups (蠂 ~ 2 / 1.812P ~ (0.178)). The incidence of perforation was less than 45.59 years old in those aged 44 years or more, and 22.815.0% (17.2%) in those aged more than 60 years. There was no significant difference between perforation group and non-perforation group (蠂 ~ 2 = 2.036) (蠂 ~ 2 / 036). The highest body temperature, preoperative pulse, preoperative respiratory frequency and abnormal urine routine were significantly different between perforation group and non-perforation group (P 0.05). The results of multivariate Logistic regression analysis showed that the highest body temperature before operation was higher than that in control group. Hosmer-Lemeshow test showed that the accurate rate of prediction was 79.1%. Conclusion the incidence of acute appendicitis perforation is about 1 / 5, and the highest body temperature before operation. Preoperative pulse and LCP were the factors influencing perforation in appendicitis patients. LCP, as a new factor closely related to perforation, was incorporated into Logistic regression model, which was helpful to predict perforation.
【作者单位】：安徽省明光市人民医院普外科;安徽医科大学第一附属医院普外科;
【分类号】：R574.61

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