粘膜尾炎:它如何与非尾炎区分?
Carlos Delgado-Miguel1,2,3, Miriam Miguel-Ferrero2, Bonifacio Delgado4
1Department of Pediatric Surgery, Prisma Health Children's Hospital, Columbia, SC, US.
American journal of clinical pathology
|July 21, 2023
概括
粘膜尾炎是急性尾炎的早期阶段,表现出明显的炎症标志物. 较高的白细胞和中性粒细胞数量,包括中性粒细胞与淋巴细胞的比率,使其与负尾切除术区别开来,有助于诊断.
科学领域:
- 儿科手术 儿科手术
- 胃肠道病理 胃肠道病理
- 诊断成像 诊断成像 诊断成像
背景情况:
- 粘膜尾炎 (MA) 是一个有争议的实体,其特点是尾粘膜的有限的中性恋透.
- 区分MA和负尾炎 (NA) 对于准确的诊断和治疗至关重要.
研究的目的:
- 调查粘膜尾炎是否代表急性尾炎 (AA) 的早期阶段.
- 根据临床和实验室发现,确定MA是否可以从负尾切除中区分开来.
主要方法:
- 对1269名因疑似尾炎而接受尾切除手术的儿童 (2017-2020) 的回顾性分析.
- 组织学分类为MA (30例) 和NA (25例) 组.
- 群体之间的人口,临床,超声波和实验室参数的比较.
主要成果:
- 在MA和NA组之间,在人口统计,临床或超声波特征上没有显著差异.
- 马氏甲基组的白细胞和中性粒细胞数量以及中性粒细胞与淋巴细胞的比率 (NLRs) 显著增加 (P < .001).
- 对于MA诊断,NLR显示了曲线下的最高面积 (0.736),截止值为3.20,提供62.5%的灵敏度和78.9%的特异性.
结论:
- 粘膜尾炎表现出明显的实验室和组织学炎症特征,支持其被归类为急性尾炎谱内的病理实体.
- 手术前白细胞和中性粒细胞计数,以及NLRs,可以帮助减少负尾切除术.
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