Gigabhoy Ritesh, Cheddie Shalen, Singh Bhugwan
1Nelson R Mandela School of Medicine, College of Health Science, Department of General Surgery, King Edward VIII Hospital, University of KwaZulu-Natal, Durban, South Africa.
2Nelson R Mandela School of Medicine, College of Health Science, Department of General Surgery, Madadeni Hospital, University of KwaZulu-Natal, Durban, South Africa.
Indian J Surg. 2018 Jun;80(3):207-210. doi: 10.1007/s12262-016-1564-0. Epub 2016 Oct 26.
The relationship between HIV infection and the clinical spectrum of appendicitis has not been fully elucidated in the South African context. The aim of this study is to compare the surgical management, histopathology, and outcomes between HIV-positive and HIV-negative patients undergoing surgery for appendicitis. A retrospective chart analysis was performed of 50 patients who underwent surgery for appendicitis at King Edward VIII Hospital, Durban, South Africa between January 2012 and December 2012. Patients were stratified by HIV serostatus into HIV-positive and HIV-negative groups. Fifty patients underwent surgery for appendicitis during the study period. Of the 50 patients, 14 were HIV-positive (28 %) and 36 were HIV-negative (72 %). Perforated appendicitis was more frequent in the HIV-positive group (50 vs. 25 %, > 0.05). There was a significantly higher laparotomy rate in HIV-positive patients (71 vs. 33 %, < 0.05). Granulomatous inflammation of the appendix was only noted in HIV-positive patients ( = 3). There was no significant difference in the complication rate between the two groups () and no difference in the mean length of hospital stay (7.8 ± 4.89 vs. 5.8 ± 3.94 days, > 0.05). In this retrospective study, perforated appendicitis was seen to be more common in HIV-positive patients resulting in a higher laparotomy rate in this group. Granulomatous inflammation was only found in HIV-positive patients. There was no difference seen in the complication rate, length of hospital stay, and mortality between HIV-positive and HIV-negative patients.
在南非背景下，HIV感染与阑尾炎临床谱之间的关系尚未完全阐明。本研究的目的是比较因阑尾炎接受手术的HIV阳性和HIV阴性患者的手术管理、组织病理学及预后情况。对2012年1月至2012年12月期间在南非德班爱德华八世医院因阑尾炎接受手术的50例患者进行了回顾性病历分析。患者按HIV血清学状态分为HIV阳性组和HIV阴性组。在研究期间，50例患者接受了阑尾炎手术。其中，14例为HIV阳性（28%），36例为HIV阴性（72%）。HIV阳性组穿孔性阑尾炎更为常见（50%对25%，P>0.05）。HIV阳性患者的剖腹手术率显著更高（71%对33%，P<0.05）。阑尾肉芽肿性炎症仅在HIV阳性患者中发现（n=3）。两组之间的并发症发生率无显著差异（P>0.05），平均住院时间也无差异（7.8±4.89天对5.8±3.94天，P>0.05）。在这项回顾性研究中，穿孔性阑尾炎在HIV阳性患者中更为常见，导致该组剖腹手术率更高。肉芽肿性炎症仅在HIV阳性患者中发现。HIV阳性和HIV阴性患者在并发症发生率、住院时间和死亡率方面未见差异。
