Department of Paediatric Surgery, Faculty of Medicine, Inonu University, Malatya, Turkiye.
Department of Bioistatistics, Faculty of Medicine, Erciyes University, Kayseri, Turkiye.
Afr J Paediatr Surg. 2023 Apr-Jun;20(2):130-137. doi: 10.4103/ajps.ajps_128_21.
In this study, we prospectively investigated changes in serum interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP) and full white blood cell (WBC) counts during the diagnosis and treatment of paediatric patients with appendicitis. We also investigated the effects of the COVID-19 pandemic on the diagnosis and treatment processes of paediatric appendicitis patients.
A non-perforated appendicitis group (n = 110), a perforated appendicitis group (n = 35) and an appendicitis + COVID-19 group (n = 8) were formed. Blood samples were taken upon admission and every day until the three studied parameters returned to normal values. To investigate the effects of the COVID-19 pandemic on paediatric appendicitis patients, the perforated appendicitis rates and the times from the onset of the first symptoms to the operation before and during the pandemic were compared.
WBC, IL-6, and hsCRP dropped below the upper limits on the second postoperative day in the non-perforated appendicitis group, four to six days postoperatively in the perforated appendicitis group, and three to six days postoperatively in the appendicitis + COVID-19 group. These parameters were not within normal range in patients who developed complications during follow-up. The time from the onset of abdominal pain to the surgery was significantly longer during than before the pandemic in both the non-perforated appendicitis group and the perforated appendicitis group.
Our results show that WBC, IL-6, and hsCRP are useful laboratory parameters that can complete clinical examinations in the diagnosis of appendicitis in paediatric patients and the identification of complications that may develop postoperatively.
本研究前瞻性地调查了儿童阑尾炎患者在诊断和治疗过程中血清白细胞介素 6（IL-6）、高敏 C 反应蛋白（hsCRP）和全白细胞计数的变化，并探讨了 COVID-19 大流行对儿童阑尾炎患者诊断和治疗过程的影响。
将非穿孔性阑尾炎组（n=110）、穿孔性阑尾炎组（n=35）和阑尾炎+COVID-19 组（n=8）。入院时及术后每天采集血样，直至三种研究参数恢复正常。为了探讨 COVID-19 大流行对儿童阑尾炎患者的影响，比较了大流行前后穿孔性阑尾炎发生率和从首发症状到手术的时间。
非穿孔性阑尾炎组术后第 2 天，穿孔性阑尾炎组术后第 4-6 天，阑尾炎+COVID-19 组术后第 3-6 天，WBC、IL-6 和 hsCRP 降至正常范围。在随访期间发生并发症的患者中，这些参数仍未在正常范围内。腹痛至手术的时间在非穿孔性阑尾炎组和穿孔性阑尾炎组均较大流行前明显延长。
我们的研究结果表明，WBC、IL-6 和 hsCRP 是有用的实验室参数，可在儿童阑尾炎的诊断中辅助临床检查，并识别术后可能发生的并发症。
