急性阑尾炎患者白细胞减少的原因分析及治疗体会  

Cause analysis and treatment experience of patients with acute appendicitis with leukopenia

作　　者：汪雄 熊卫锋[1] 刘春安 WANG Xiong;XIONG Wei-feng;LIU Chun-an(Department of Gastrointestinal Surgery,Ji'an Central People's Hospital,Ji'an 343100,China)

机构地区：[1]吉安市中心人民医院胃肠外科,343100

出　　处：《中国实用医药》2025年第6期52-55,共4页China Practical Medicine

摘　　要：目的 探究急性阑尾炎患者白细胞减少的原因及治疗效果。方法 回顾性分析21例白细胞减少急性阑尾炎患者的临床资料。结果 21例患者中,13例行腹腔镜手术治疗,3例行开放手术治疗,5例行保守治疗。保守治疗患者中,诊断为急性阑尾炎的有4例,急性阑尾炎并局限性腹膜炎的有1例;手术治疗患者中,诊断为急性单纯性阑尾炎的有1例,急性单纯性阑尾炎并局限性腹膜炎的有5例,急性化脓性阑尾炎并局限性腹膜炎的有1例,急性坏疽性阑尾炎并局限性腹膜炎的有4例,急性坏疽性阑尾炎并弥漫性腹膜炎的有5例。经治疗后,所有患者白细胞计数均回升,所有患者均治愈出院。21例患者中,有基础疾病的患者6例,其中艾滋病1例,长期口服抗病毒药物治疗;再生障碍性贫血1例,口服环孢素治疗;肾功能衰竭1例,长期透析治疗;多囊卵巢综合征1例,未予治疗;脑梗死1例,长期口服阿司匹林肠溶片、辛伐他汀治疗;慢性结肠炎1例,间断给予益生菌制剂及止泻药物治疗。经过检验发现肝功能异常4例;免疫功能紊乱1例;弥漫性腹膜炎5例;菌血症1例;入院前有药物治疗史2例,1例口服双氯芬酸钠肠溶片,另1例外院给予哌拉西林钠他唑巴坦钠抗感染治疗;既往有阑尾炎发作史4例。结论 急性阑尾炎患者白细胞减少可能与重症感染、基础疾病、药物等有关,治疗前应充分询问既往病史及治疗史,结合腹部体征,及时诊断及治疗。Objective To investigate the causes and therapeutic effects of leukopenia in patients with acute appendicitis.Methods A retrospective analysis was conducted on 21 cases of acute appendicitis patients with leukopenia.Results Of the 21 patients,13 cases had laparoscopic surgery,3 cases had open surgery,and 5 cases had conservative treatment.Among the patients treated conservatively,4 cases were diagnosed with acute appendicitis and 1 case was diagnosed with acute appendicitis combined with localized peritonitis;among the patients treated with surgery,1 case was diagnosed as acute simple appendicitis,5 cases were diagnosed as acute simple appendicitis with localized peritonitis,1 case was diagnosed as acute suppurative appendicitis with localized peritonitis,4 cases were diagnosed as acute gangrenous appendicitis with localized peritonitis,and 5 cases were diagnosed as acute gangrenous appendicitis with diffuse peritonitis.After treatment,the white blood cell count of all patients recovered,and all patients were cured and discharged.After treatment,all patients' white blood cell counts rebounded,and all patients were cured and discharged from the hospital.Among the 21 patients,there were 6 patients with underlying diseases,including;1 case of AIDS,treated with long-term oral antiviral drugs;1 case of aplastic anemia,treated with oral cyclosporine;1 case of renal failure,treated with longterm dialysis;1 case of polycystic ovary syndrome,not treated 1 case of cerebral infarction,treated with long-term oral aspirin enteric-coated tablets and simvastatin;1 case of chronic colitis,intermittently treated with probiotic preparations and antidiarrheal drugs.Tests revealed abnormal liver function in 4 cases,immune dysfunction in 1 case,diffuse peritonitis in 5 cases,bacteremia in 1 case;before admission,2 cases had a history of drug treatment,including 1 case took diclofenac sodium enteric-coated tablets orally,and the other case received anti-infection treatment with piperacillin sodium and tazobactam sodium;4 cases had a h

关 键 词：白细胞减少 急性阑尾炎 重症感染 

分 类 号：R656.8[医药卫生—外科学]