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探讨血清炎症参数在复杂型急性胆囊炎诊断中的预测作用。

An investigation into the predictive role of serum inflammatory parameters in the diagnosis of complicated acute cholecystitis.

机构信息

Department of General Surgery, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul-Turkey.

Department of General Surgery, İstanbul Kartal Dr. Lütfi Kırdar Training and Research Hospital, İstanbul-Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2022 Jun;28(6):818-823. doi: 10.14744/tjtes.2021.35923.

Abstract

BACKGROUND

Gallbladder gangrene and perforation are an important complication of acute calculous cholecystitis and are dif-ficult to detect preoperatively. Therefore, in this study, we aimed to evaluate whether serum inflammatory parameters are predictive factors for complicated cholecystitis (CC).

METHODS

In the present study, histopathological findings of 250 patients who were operated on with the diagnosis of acute chole-cystitis (AC) in the emergency department between 2014 and 2019 were evaluated and the cases were divided into two groups as AC and CC. Parameters, including age, gender, body mass index, white blood cell (WBC) count, C-reactive protein (CRP), neutrophil-to-lym-phocyte ratio (NLR), mean platelet volume (MPV), and platelet distribution width (PDW), were examined for their ability to predict CC.

RESULTS

The findings obtained in this study showed that WBC, CRP, and NLR were significantly higher in the CC group (p<0.05). WBC >9.000 cells/ml, CRP >29.0, and NLR >4.3 were the factors that could predict CC. There was no significant difference between the two groups concerning MPV and PDW (p>0.05). CC was observed more frequently in patients over 65 years of age, but there was not a statistically significant difference (p=0468).

CONCLUSION

WBC, CRP, and NLR are valuable biochemical markers in predicting complicated AC. Advanced age may be a help-ful predictive factor for CC. These factors may be helpful in making an early cholecystectomy decision.

摘要

背景

胆囊坏疽穿孔是急性结石性胆囊炎的重要并发症,术前难以发现。因此,本研究旨在评估血清炎症参数是否是复杂胆囊炎(CC)的预测因素。

方法

本研究回顾性分析了 2014 年至 2019 年在急诊科因急性胆囊炎(AC)接受手术的 250 例患者的组织病理学发现,并将病例分为 AC 和 CC 两组。检查了包括年龄、性别、体重指数、白细胞(WBC)计数、C 反应蛋白(CRP)、中性粒细胞与淋巴细胞比值(NLR)、平均血小板体积(MPV)和血小板分布宽度(PDW)在内的参数,以评估其预测 CC 的能力。

结果

本研究结果显示,CC 组的 WBC、CRP 和 NLR 明显更高(p<0.05)。WBC>9.000 个细胞/ml、CRP>29.0 和 NLR>4.3 是预测 CC 的因素。两组间 MPV 和 PDW 无显著差异(p>0.05)。年龄超过 65 岁的患者中 CC 更为常见,但无统计学差异(p=0.468)。

结论

WBC、CRP 和 NLR 是预测复杂 AC 的有价值的生化标志物。高龄可能是 CC 的一个有用的预测因素。这些因素可能有助于早期决定行胆囊切除术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/489f/10443025/e4c3a2855159/TJTES-28-818-g001.jpg

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