儿童急性尾炎:手术前的低血是穿孔/炎的预测因素吗? 一个前性研究研究
Ahmed Elgendy1, Mohammad Gharieb Khirallah2, Mohamed Elsawaf2
1Surgical Oncology Unit, Department of Surgery, Faculty of Medicine, Tanta University, 35 Ali Beek Elkbeer Street, Tanta, 31515, Egypt. ahmed.elgendy@med.tanta.edu.eg.
低血水平或低血水平是识别儿童穿孔尾炎的新标志物. 对于患有低血症和疑似尾炎的儿童,建议立即进行手术.
科学领域:
- 儿科手术 儿科手术
- 生物化学 生物化学
- 诊断标记器 诊断标记器
背景情况:
- 在儿童中区分无并发性尾炎和穿孔/尾炎对于适当的治疗至关重要.
- 目前的诊断方法可能并不总是准确地区分尾炎的严重程度.
- 低血症正在作为一种潜在的新诊断标记物被探索.
研究的目的:
- 评估低血症作为小儿科患者穿孔/带性尾炎的新型诊断标志物.
- 为了比较患有无并发尾炎和并发尾炎的儿童之间的血清水平.
- 评估低血症在确定严重尾炎的预测价值.
主要方法:
- 对153名患有急性尾炎的儿童进行尾切除的前性研究 (2021年5月至2023年5月).
- 在入院时分析病史,临床标准和血液样本 (电解质,炎症标志物).
- 患者被分为无并发症 (I 组) 和穿孔/带性尾炎 (II 组) 进行比较分析.
主要成果:
- 穿孔/性尾炎 (131.8 mmol/L) 和无并发症 (138.7 mmol/L) (p < 0.001) 的平均血清含量显著降低.
- 切割点血清水平<135 mmol/L确定了穿孔/带性尾炎,敏感度为94%和特异性为91% (AUC = 0.981).
- 预测因素包括年龄<5岁,症状持续时间>24小时,发烧>38.5°C,低血症和CRP升高.
结论:
- 住院时的低血是儿童穿孔/尾炎的新型客观生化标志物.
- 血清度评估应纳入疑似儿童尾炎的诊断算法.
- 在患有低血和疑似尾炎的儿科患者中,不应推迟手术干预;应避免非手术治疗.
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