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肝移植与非肝移植患者因疑似急性阑尾炎而行阑尾切除术:病例对照研究。

Liver transplant versus non-liver transplant patients underwent appendectomy with presumed diagnosis of acute appendicitis: Case-control study.

机构信息

Department of Surgery and Liver Transplant Institute and, İnönü University Faculty of Medicine, Malatya-Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2020 Sep;26(5):705-712. doi: 10.14744/tjtes.2020.52368.

Abstract

BACKGROUND

This study aims to compare liver transplant and non-liver transplant patients who underwent appendectomy with a presumed diagnosis of acute appendicitis.

METHODS

Demographic and clinicopathological features of 13 liver transplant recipients (transplant group) who underwent posttransplant appendectomy with a presumed diagnosis of acute appendicitis were compared with the features of 52 non-liver transplant patients (non-transplant group). They underwent appendectomy with a presumed diagnosis of acute appendicitis during the same time period. The transplant group was matched at random in a 1: 4 ratio with the non- transplant group. While the continuous variables were compared using the Mann Whitney-U test, categorical variables were compared with Fisher's exact test. A p-value of less than 0.05 was considered statistically significant.

RESULTS

A total of 65 patients aged between one year and 84 years were included in this study. While the age of the 52 patients (32 male and 20 female) in the non- transplant group ranged from 17 years to 84 years, the age of the 13 patients (nine male and four female) in the transplant group ranged from one year to 64 years. Statistically significant differences were noted between both groups concerning WBC (p=0.002), neutrophil (p=0.002), lymphocyte (p=0.032), platelets (p=0.032), RDW (p=0.001), CRP (p=0.009), PNR (p=0.042), WNR (p=0.03), and appendiceal length (p<0.001). The negative appendectomy rate was relatively higher in transplant than the non-transplant group but this difference was not statistically significant (30.8% vs. 21.2%; p=0.477). Perforated acute appendicitis occurred more frequently in the transplant group; however, this difference was not statistically significant (30.8% vs. 9.6%; p=0.070).

CONCLUSION

WBC and neutrophil were lower in the LT group; however, the CRP and RDW were higher in the LT group. Further, perforation and negative appendectomy rates were higher in the LT group, although this difference was not statistically significant.

摘要

背景

本研究旨在比较经移植和非移植患者行疑似急性阑尾炎切除术的结果。

方法

对比了 13 例接受移植后疑似急性阑尾炎切除术的肝移植患者(移植组)和 52 例同期行疑似急性阑尾炎切除术的非肝移植患者(非移植组)的人口统计学和临床病理学特征。移植组按 1:4 的比例随机与非移植组匹配。连续变量采用 Mann-Whitney-U 检验进行比较,分类变量采用 Fisher 确切检验进行比较。p 值<0.05 被认为具有统计学意义。

结果

共有 65 例年龄在 1 岁至 84 岁的患者纳入本研究。非移植组 52 例患者(32 名男性,20 名女性)的年龄范围为 17 岁至 84 岁,而移植组 13 例患者(9 名男性,4 名女性)的年龄范围为 1 岁至 64 岁。两组间白细胞计数(WBC)(p=0.002)、中性粒细胞计数(p=0.002)、淋巴细胞计数(p=0.032)、血小板计数(p=0.032)、红细胞分布宽度(RDW)(p=0.001)、C 反应蛋白(CRP)(p=0.009)、中性粒细胞与淋巴细胞比值(PNR)(p=0.042)、白细胞与中性粒细胞比值(WNR)(p=0.03)和阑尾长度(p<0.001)均有统计学差异。移植组阴性阑尾切除率相对较高,但差异无统计学意义(30.8%比 21.2%;p=0.477)。移植组穿孔性急性阑尾炎发生率较高,但差异无统计学意义(30.8%比 9.6%;p=0.070)。

结论

与非移植组相比,LT 组的 WBC 和中性粒细胞计数较低,而 CRP 和 RDW 较高。此外,LT 组的穿孔和阴性阑尾切除率较高,尽管差异无统计学意义。

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