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实验室检查和体重指数在急性阑尾炎诊断中的重要性。

The importance of laboratory tests and Body Mass Index in the diagnosis of acute appendicitis.

机构信息

Atlas University Medical Faculty General Surgeon, Istanbul, Turkey.

Balıklı Rum Hospital, General Surgery, Istanbul, Turkey.

出版信息

Pol Przegl Chir. 2020 Aug 19;92(6):7-11. doi: 10.5604/01.3001.0014.3579.

Abstract

<b>Background:</b> Acute appendicitis is the most common cause of acute abdomen. Delay in diagnosis increases the mortality and morbidity. <br><b>Aim: </b>In this study, we aimed to investigate whether the body mass index is useful in diagnosis and whether the neutrophil /lymphocyte and platelet/lymphocyte ratios can help in determining the inflammation level of acute appendicitis. <br><b>Meterial and Methods:</b> Cases of appendectomy performed between June 2012 and December 2018 in our clinic were analyzed retrospectively. Based on the pathology results of the cases included in the study, 4 groups were formed, i.e.: Group 1 (initial stage), Group 2 (catarrhal stage), Group 3 (phlegmonous-gangrenous stage) and Group 4 (perforation). The study compared age, body mass index, leukocyte values, red cell distribution width (RDW), neutrophil/lymphocyte ratio (NLR), platelet /lymphocyte ratio (PLR), and mean platelet volume (MPV) between groups. <br><b> Results:</b> 828 cases were included in the study. When compared between groups, the values of Group 3 and Group 4 were higher than those of Group 1 and Group 2 for PLR and NLR. There was no difference in RDW and MPV values in the blood. When Body Mass Index (BMI) was compared between groups, it was found to be significantly higher with increasing histopathological stage. <br><b>Conclusion:</b> In acute appendicitis, the blood leukocyte value, elevated PLR and NLR are helpful in diagnosis. We aimed to emphasize that the diagnosis of acute appendicitis is delayed in patients with a BMI above 30 and/or at age of over 40 years, with the perforation rate being determined more frequently.

摘要

<b>背景:</b>急性阑尾炎是最常见的急腹症病因。诊断延迟会增加死亡率和发病率。<br><b>目的:</b>本研究旨在探讨体重指数(BMI)是否有助于诊断,以及中性粒细胞/淋巴细胞和血小板/淋巴细胞比值是否有助于确定急性阑尾炎的炎症水平。<br><b>材料和方法:</b>回顾性分析了 2012 年 6 月至 2018 年 12 月在我院行阑尾切除术的病例。根据纳入研究病例的病理结果,将其分为 4 组,即:第 1 组(初始阶段)、第 2 组(卡他性阶段)、第 3 组(蜂窝织炎-坏疽阶段)和第 4 组(穿孔)。研究比较了各组间的年龄、BMI、白细胞值、红细胞分布宽度(RDW)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)和平均血小板体积(MPV)。<br><b>结果:</b>本研究共纳入 828 例病例。组间比较时,PLR 和 NLR 方面,第 3 组和第 4 组的值高于第 1 组和第 2 组;而 RDW 和 MPV 值在血液中没有差异。组间比较 BMI 时,随着组织病理学分期的升高,BMI 值显著升高。<br><b>结论:</b>在急性阑尾炎中,白细胞升高、PLR 和 NLR 升高有助于诊断。我们旨在强调,BMI 超过 30 且/或年龄超过 40 岁的患者,急性阑尾炎的诊断会延迟,且穿孔率更高。

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