753例急性阑尾炎患者的临床特征及影响因素分析  

Analysis of clinical characteristics and influencing factors of 753 patients with acute appendicitis

作　　者：苏海深 黄军科 刘玉群 李文川[2] 谭力 杨字林 郭升 颜耳 张丽萍 SU Haishen;HUANG Junke;LIU Yuqun;LI Wenchuan;TAN Li;YANG Zilin;GUO Sheng;YAN Er;ZHANG Liping(Department of General Surgery,People's Hospital of Xilin County,Xilin 533500,Guangxi,China;Department of Hepatobiliary Surgery,Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China)

机构地区：[1]广西百色市西林县人民医院普通外科,广西西林533500 [2]右江民族医学院附属医院肝胆外科,广西百色533000

出　　处：《右江医学》2024年第6期508-513,共6页Chinese Youjiang Medical Journal

基　　金：百色市科学研究与技术开发计划课题(百科20220928)。

摘　　要：目的探讨急性阑尾炎(AA)的临床特征及其严重程度的影响因素,以期为急性阑尾炎的诊断和病情评估提供参考。方法回顾性分析西林县人民医院2019年1月—2021年12月行阑尾切除手术患者的临床资料。根据术后病理结果分为非复杂性阑尾炎组(非复杂组)和复杂性阑尾炎组(复杂组),比较两组年龄、性别、有无转移性右下腹症状、伴随症状、腹膜刺激征、白细胞计数、中性粒细胞计数、淋巴细胞计数、C反应蛋白、纤维蛋白原、总胆红素、红细胞压积、血清白蛋白等因素;建立数据库,进行统计学分析,并找出两组数据显著差异变量,采用多因素logistic回归分析影响AA严重程度的因素。结果根据筛选标准,753例患者纳入研究对象,其中230例患者为复杂组。差异性分析结果显示,复杂组的术中出血、住院天数、白细胞计数、中性粒细胞计数、中性粒细胞百分比、红细胞压积、C反应蛋白、总胆红素、纤维蛋白原均高于非复杂组(P<0.05或0.001);而复杂组淋巴细胞计数、淋巴细胞百分比、血清白蛋白均低于非复杂组(P<0.001)。多因素logistic回归分析结果显示,总胆红素、C反应蛋白、红细胞压积是急性阑尾炎严重程度的独立危险因素(P<0.01);而纤维蛋白原、血清白蛋白是急性阑尾炎严重程度的独立保护因素(P<0.05)。结论总胆红素、C反应蛋白、红细胞压积、纤维蛋白原、血清白蛋白可能是急性阑尾炎严重程度的影响因素。Objective To explore the clinical characteristics of acute appendicitis(AA)and the influencing factors of its severity,so as to provide reference for the diagnosis and evaluation of AA.Methods The clinical data of patients who underwent appendectomy in the People's Hospital of Xilin County from January 2019 to December 2021 were retrospectively analyzed.According to postoperative pathological results,patients were divided into uncomplicated appendicitis group(uncomplicated group)and complicated appendicitis group(complicated group).Factors such as age,sex,symptoms of right lower abdomen metastasis,accompanying symptoms,peritonitis irritation,white blood cell count,neutrophil count,lymphocyte count,C-reactive protein,fibrinogen,total bilirubin,hematocrit and serum albumin were compared between the two groups.A database was established,statistical analysis was carried out,variables with significant differences between the two sets of data were found out,and multivariate logistic regression was used to analyze the factors affecting the severity of AA.Results According to screening criteria,753 patients were enrolled,with 230 patients included in the complicated group.The results of difference analysis showed that intraoperative bleeding,length of stay,white blood cell count,neutrophilcount,neutrophil percentage,hematopoietic volume,C-reactive protein,total bilirubin and fibrinogen in the complicated group were all higher than those in the uncomplicated group(P<0.05 or 0.001),while the lymphocyte count,the percentage of lymphocyte and serum albumin in the complicated group were lower than those in the uncomplicated group(P<0.001).Multivariate logistic analysis showed that total bilirubin,C-reactive protein and hematocrit were independent risk factors for the severity of AA(P<0.01),while fibrinogen and serum albumin were independent protective factors for the severity of AA(P<0.05).Conclusion Total bilirubin,C-reactive protein,hematocrit,fibrinogen and serum albumin may be the influencing factors for the severity of A

关 键 词：急性阑尾炎 复杂性阑尾炎 C反应蛋白 纤维蛋白原 影响因素 

分 类 号：R656.8[医药卫生—外科学]