本文選題：闌尾炎　切入點(diǎn)：闌尾炎穿孔　出處：《中國全科醫(yī)學(xué)》2017年17期 　論文類型：期刊論文

【摘要】：目的探討C反應(yīng)蛋白(CRP)及白細(xì)胞計(jì)數(shù)、中性粒細(xì)胞分?jǐn)?shù)等炎性指標(biāo)診斷闌尾炎穿孔的價(jià)值。方法選取2012—2015年在寧波大學(xué)醫(yī)學(xué)院附屬鄞州醫(yī)院術(shù)前診斷為急性闌尾炎(含慢性闌尾炎急性發(fā)作)行闌尾手術(shù)(含腹腔鏡闌尾切除術(shù))患者862例。根據(jù)闌尾炎是否穿孔分為穿孔組(146例)和未穿孔組(716例)。收集患者術(shù)前同一時(shí)間點(diǎn)CRP、白細(xì)胞計(jì)數(shù)、中性粒細(xì)胞分?jǐn)?shù),繪制受試者工作特征(ROC)曲線,判斷其診斷闌尾炎穿孔的價(jià)值。結(jié)果穿孔組和未穿孔組白細(xì)胞計(jì)數(shù)、中性粒細(xì)胞分?jǐn)?shù)比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。穿孔組CRP水平高于未穿孔組(P0.05)。CRP50 mg/L時(shí),診斷闌尾炎穿孔的靈敏度是78.8%,特異度是90.9%。穿孔組與未穿孔組老年人和中青年人CRP水平比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。CRP25 mg/L時(shí),診斷老年人闌尾炎穿孔的靈敏度是82.4%,特異度是81.0%。CRP50 mg/L時(shí),診斷中青年人闌尾炎穿孔的靈敏度是80.2%,特異度是89.7%。結(jié)論白細(xì)胞計(jì)數(shù)、中性粒細(xì)胞分?jǐn)?shù)在術(shù)前無法準(zhǔn)確診斷闌尾炎是否穿孔,但CRP可作為診斷急性闌尾炎是否穿孔的指標(biāo),并且診斷價(jià)值在中青年患者中較老年患者強(qiáng)。
[Abstract]:Objective to study the C-reactive protein (CRP) and white blood cell count (WBC). Value of inflammatory markers such as neutrophil fraction in the diagnosis of appendicitis perforation methods appendicitis was diagnosed as acute appendicitis (including acute attack of chronic appendicitis) from 2012 to 2015 at Yinzhou Hospital affiliated to Ningbo University Medical College. 862 patients (including laparoscopic appendectomy) were divided into perforation group (n = 146) and non-perforation group (n = 716) according to whether the appendicitis was perforated. Results the neutrophil fraction (neutrophil fraction) curve was drawn to determine the diagnostic value of appendicitis perforation. Results the leukocyte count and neutrophil fraction were compared between perforation group and unperforated group. When the CRP level in perforation group was higher than that in unperforated group, the sensitivity of diagnosis of appendicitis perforation was 78.8, and the specificity was 90.9.The CRP level in the perforation group was higher than that in the elderly and middle and young people without perforation. The sensitivity of diagnosis of appendicitis perforation in the elderly was 82.4, the specificity was 81.0. CRP50 mg/L, the sensitivity of young patients with appendicitis perforation was 80.2 and the specificity was 89.70.Conclusion White blood cell count is the most important factor in the diagnosis of appendicitis perforation. Neutrophil fraction could not accurately diagnose perforation of appendicitis before operation, but CRP could be used as an index to diagnose perforation of acute appendicitis, and the diagnostic value of neutrophil fraction was stronger in young and middle-aged patients than in elderly patients.
【作者單位】： 寧波大學(xué)醫(yī)學(xué)院附屬鄞州醫(yī)院普外科;
【分類號(hào)】：R656.8

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