Harland R N
Booth Hall Children's Hospital, Blackley, Manchester, UK.
J R Coll Surg Edinb. 1991 Apr;36(2):89-90.
A retrospective study of the diagnostic value of the blood white cell count was carried out in 187 children who had had an appendicectomy for suspected appendicitis. All had preoperative measurement of the total white cell count. Normal appendices were present in 43 children (23%), with a mean white cell count of 9.5 x 10(6)/l (95% confidence interval 8.4-10.6). The 144 children with appendicitis had a mean white cell count of 16.1 x 10(6)/l (95% confidence interval 15.3-16.9). A white cell count of 10 x 10(6)/l gave the best discrimination, and 91% of patients with a white cell count which equalled or exceeded this value had appendicitis compared with 27% of patients with a lower total white cell count (P less than 0.0001). Only one patient of 46 with gangrenous or perforated appendicitis had a white cell count below 10 x 10(6)/l. In children with suspected appendicitis a low white cell count should lead to review of the diagnosis and to further observation when doubt about the need for surgery persists.
对187例因疑似阑尾炎而接受阑尾切除术的儿童进行了一项关于白细胞计数诊断价值的回顾性研究。所有患儿术前均测量了白细胞总数。43名儿童（23%）阑尾正常，白细胞计数平均值为9.5×10⁶/l（95%置信区间8.4 - 10.6）。144例阑尾炎患儿白细胞计数平均值为16.1×10⁶/l（95%置信区间15.3 - 16.9）。白细胞计数为10×10⁶/l时鉴别效果最佳，白细胞计数等于或超过该值的患者中91%患有阑尾炎，而白细胞总数较低的患者中这一比例为27%（P＜0.0001）。46例坏疽性或穿孔性阑尾炎患者中只有1例白细胞计数低于10×10⁶/l。对于疑似阑尾炎的儿童，白细胞计数低时应重新评估诊断，当对是否需要手术仍有疑问时应进一步观察。
