摘要
目的探索急性阑尾炎穿孔的相关危险因素。方法回顾性分析2016年1月至2017年12月接受手术的急性阑尾炎患者,依据术中所见和术后病理诊断结果将患者分为穿孔组和未穿孔组。穿孔组150例,未穿孔组157例。比较研究患者病程、发病至手术时间、术前最高体温、术前脉搏、记录实验室检查项目:白细胞计数(WBC)、中性粒细胞分数(NCP)、淋巴细胞分数(LCP)、红细胞压积(HCT)、C反应蛋白(CRP)、总蛋白。采用Logistic回归分析影响急性阑尾炎发生穿孔的危险因素。结果穿孔组与未穿孔组术前最高体温、术前脉搏、WBC、NCP、LCP、CRP[(37.98±0.54)℃比(37.58±0.52)℃、(94.94±20.74)次/min比(87.41±15.35)次/min、(15.25±4.71)×109/L比(11.04±4.29)×109/L、(83.06±9.84)%比(75.27±13.71)%、(11.76±3.73)%比(18.23±5.72)%、(89.35±23.10)mg/L比(52.16±18.46)mg/L]比较差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,WBC(OR=1.185,95%CI1.090~1.280)、CRP(OR=2.043,95%CI1.243~2.843),术前最高体温(OR=2.007,95%CI1.114~3.616)、术前脉搏(OR=1.160,95%CI1.124~1.196)是急性阑尾炎发生穿孔的危险因素(P<0.05)。模型经Hosmer-Lemeshow检验(χ2=13.571,P=0.912),预测正确率为76.21%。结论WBC、CRP、术前最高体温、术前脉搏是急性阑尾炎患者发生穿孔的危险因素,有助于急性阑尾炎患者发生穿孔的预测。
Objective To identify risk factors of perforation in acute appendicitis.Methods Patients with acute appendicitis who underwent surgical treatment from 2016 January to 2017 December were retrospectively reviewed.According to clinical and pathological records,patients were divided into perforation group(including 150 patients)and non-perforation group(including 157 patients).The progress of disease,duration from occurrence to surgery,preoperative highest temperature and pulse rate,and a series of indicators including WBC,NCP,LCP,HCT,CRP,TP through blood routine or biochemical assays.Logistic regression analysis was adopted to analyze the risk factors of perforation were compared.Results Preoperative highest temperature,pulse rate,WBC,NCP,LCP and CRP in perforation and non-perforation group were(37.98±0.54)℃ vs.(37.58±0.52)℃,(94.94±20.74)times/min vs.(87.41±15.35)times/min,(15.25±4.71)×109/L vs.(11.04±4.29)×109/L,(83.06±9.84)% vs.(75.27±13.71)%,(11.76±3.73)% vs.(18.23±5.72)%,(89.35±23.10)mg/L vs.(52.16±18.46)mg/L,respectively.There existed significant differences between the two groups(P<0.05).Logistic regression analysis showed that WBC(OR=1.185,95% CI 1.090-1.280),CRP(OR=2.043,95% CI 1.243-2.843),the preoperative highest temperature(OR=2.007,95% CI 1.114-3.616),and pulse rate(OR=1.160,95% CI 1.124-1.196)were risk factors of perforation in patients with acute appendicitis(P<0.05).The Hosmer-Lemeshow test proved that the predictive accuracy rate of the Logistic model was up to 79.1%.Conclusions WBC,CRP,the preoperative highest temperature and pulse rate are risk factors,which contributes to predict the risk of perforation in patients with acute appendicitis.
作者
李和禹
王举
Li Heyu;Wang Ju(Department of Gastroenterology,People's Hospital of lnner Mongolia,Hohhot 010017,China)
出处
《中国医师进修杂志》
2018年第12期1057-1060,共4页
Chinese Journal of Postgraduates of Medicine
基金
内蒙古自然科学基金(2016MS0835).
关键词
阑尾炎
穿孔
危险因素
Acute appendicitis
Perforation
Risk factors
