Department of General Surgery, Başkent University Faculty of Medicine, Ankara-Türkiye.
Ulus Travma Acil Cerrahi Derg. 2022 Sep;28(9):1238-1247. doi: 10.14744/tjtes.2022.46944.
The physiological response of the immune system to various stress factors results in an increase in neutrophil count and a decrease in lymphocyte count. In the light of this information, some studies have suggested using the ratio of these two parameters as an infection marker. The aim of this study was to investigate the role of neutrophil-to-lymphocyte ratio (NLR) derived from complete blood count, a very cost-effective and rapidly measurable parameter, in predicting the urgency of the surgical indication and disease progression in intestinal obstructions secondary to benign causes.
The data of patients who were admitted with the diagnosis of intestinal obstruction secondary to benign causes and underwent surgical intervention between January 2010 and January 2021 in Başkent University, Faculty of Medicine, Department of General Surgery, Konya Practice and Research Hospital were retrospectively analyzed. The data of 109 patients who met the study criteria and were included in the study were statistically analyzed. The correlation of admission NLR with factors indicating the severity of the disease such as intraoperatively detected ischemia, perforation, resection requirement, post-operative morbidity and mortality, and length of hospital stay was examined. Moreover, the diagnostic value of the NLR was compared with that of other infection markers (such as C-reactive protein [CRP] and leukocyte).
It was observed that the high NLR during admission to the hospital due to benign intestinal obstruction causes significantly increased the risk of ischemia, resection requirement, post-operative complications, and mortality during surgery (p<0.05). Furthermore, increased NLR was found to be associated with prolonged hospitalization. In correlation analysis, consistent with the literature, a positive correlation was found between NLR and hospitalization time (p=0.03), CRP value (p<0.001), ischemia (p<0.001), perforation (p=0.007), presence of post-operative complications (p=0.009), and mortality (p=0.002).
Our results show that the NLR has a very important role in predicting the course of the disease and surgical indication in benign intestinal obstructions.
免疫系统对各种应激因素的生理反应会导致中性粒细胞计数增加和淋巴细胞计数减少。基于这一信息，一些研究提出使用这两个参数的比值作为感染标志物。本研究旨在探讨来自全血细胞计数的中性粒细胞与淋巴细胞比值（NLR）在预测良性病因引起的肠梗阻手术指征和疾病进展中的作用。
回顾性分析 2010 年 1 月至 2021 年 1 月期间在 Başkent 大学医学院普外科、Konya 实践与研究医院因良性病因导致肠梗阻并接受手术干预的患者数据。对符合研究标准并纳入研究的 109 例患者的数据进行了统计学分析。研究了入院时 NLR 与术中发现的缺血、穿孔、切除需求、术后发病率和死亡率以及住院时间等提示疾病严重程度的因素之间的相关性。此外，还比较了 NLR 与其他感染标志物（如 C 反应蛋白[CRP]和白细胞）的诊断价值。
观察到良性肠梗阻患者因入院时 NLR 较高，手术时显著增加了缺血、切除需求、术后并发症和死亡率的风险（p<0.05）。此外，发现 NLR 升高与住院时间延长有关。在相关性分析中，与文献一致，NLR 与住院时间（p=0.03）、CRP 值（p<0.001）、缺血（p<0.001）、穿孔（p=0.007）、术后并发症（p=0.009）和死亡率（p=0.002）呈正相关。
我们的研究结果表明，NLR 在预测良性肠梗阻的疾病过程和手术指征方面具有非常重要的作用。
