预测急性坏疽性阑尾炎的危险因素分析  

Analysis of risk factors for predicting acute gangrenous appendicitis

作　　者：倪航航[1] 梁志宏[1] 刘书强[1] 华伟[1] 韩月锋[1] 

机构地区：[1]广东省中山市小榄人民医院普外一区,528415

出　　处：《临床外科杂志》2017年第8期625-627,共3页Journal of Clinical Surgery

摘　　要：目的比较急性坏疽性阑尾炎与急性单纯性阑尾炎的各项生化指标,分析急性坏疽性阑尾炎的危险预测因素。方法阑尾切除术后病理诊断为急性坏疽性阑尾炎和急性单纯性阑尾炎的患者291例,其中急性单纯性阑尾炎患者217例(单纯组),急性坏疽性阑尾炎患者74例(坏疽组),比较两组患者术前各项生化指标的差异,运用多因素分析得出急性坏疽性阑尾炎的独立危险因素,然后再运用受试者工作特征曲线(ROC)分析其敏感性、特异性和截点值。结果坏疽组患者白细胞、嗜中性粒细胞比例、总胆红素、C反应蛋白(C-reactive protein,CRP)值高于单纯组;血小板值低于单纯组,两组比较,差异均有统计学意义(P<0.05)。在多因素统计中,总胆红素和CRP是预测急性坏疽性阑尾炎的独立危险因素(P<0.05),CRP和总胆红素的敏感性、特异性、截点值分别为75.7%、86.2%、45.32 mg/L和71.6%、58.1%、12.05μmol/L。结论 CRP可能是预测急性坏疽性阑尾炎的重要血清学标志物,对指导急性阑尾炎的治疗有一定的价值。Objective To investigate acute gangrenous appendicitis and acute simple appendicitis compareded,predictive acute gangrenous appendicitis risk factors. Methods Patients in our hospital in January 2015 ~ March 2016 appendectomy,the pathological diagnosis of patients with acute gangrenous appendicitis and acute appendicitis simple total of 291 cases in which patients with acute appendicitis in217 cases of simple（ simple group）,acute gangrenous appendicitis in 74 patients（ group gangrene）,analysis preoperative biochemical indicators differences,using multivariate statistical analysis of independent risk factors derived acute gangrenous appendicitis,then use the receiver operating characteristic curve（ ROC） analysis of the sensitivity,specificity and the cut-off point value. Results In gangrene group,WBC,the proportion of neutrophils neutrophils,total bilirubin,C-reactive protein is significantly higher than the value of simple group; and the value is significantly lower platelet group simple,both statistical comparison significance（ P 0. 05）. In multivariate statistics,total bilirubin,and C-reactive protein is an independent risk factor for the prediction of acute gangrenous appendicitis（ P 0. 05）,sensitivity,specificity and cut-off values of C-reactive protein and total bilirubin were（ 75. 7%,86. 2%,45. 32 mg/L and71. 6%,58. 1%,12. 05 μmol/L）. Conclusion C-reactive protein maybe an important serological markers in predictive of acute gangrenous appendicitis,to guide treatment of acute appendicitis has clinical value.

关 键 词：急性阑尾炎 CRP 总胆红素 ROC曲线 

分 类 号：R656.8[医药卫生—外科学]