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患有免疫性降低血液恶性瘤或化疗相关的白血病患者的急性尾炎:一个队列研究

Alexandra C Klein¹, Hannah Rasel¹, Oliver Kriege²

¹Department of General, Visceral and Transplant Surgery, University Medical Centre of the Johannes Gutenberg University, Langenbeckstraße 1, 55131, Mainz, Germany.

|July 2, 2025

概括

在免疫功能低下的患者中诊断急性尾炎是困难的,因为异型症状和不可靠的评分系统. 尾切除术是安全的,但早期检测需要仔细评估和成像,特别是高C反应蛋白 (CRP).

科学领域:

在瘤学瘤学.
胃肠病学胃肠病学
手术瘤学手术瘤学

背景情况:

在患有血液性恶性瘤或化疗诱导的白血病患者中,由于炎症反应受损,急性尾炎的诊断具有挑战性.
这些患者的非典型临床表现可能导致急性尾炎的延迟或错误诊断.
标准的诊断工具和评分系统在免疫受损的个体中往往是不可靠的.

研究的目的:

为了评估血液恶性瘤或化疗诱导的白血病患者的尾切除结果.
评估临床评分系统在这个特定的患者群体中诊断急性尾炎的适用性.
为突出针对免疫功能低下患者的精细诊断和手术策略的需要.

主要方法:

对经过尾切除术 (2007-2023) 的血液恶性瘤或化疗相关白血病患者的回顾性分析.
对临床表现,实验室发现和成像结果的审查.
评估急性尾炎诊断临床评分系统的准确性和相关性.

主要成果:

十二名患有血液性恶性瘤或化疗诱导的白血病患者接受了尾切除术.
非典型的表现很常见,发烧降低和白细胞数量增加.
尾切除术显示了低的术后并发症率 (1/12) 和没有与尾炎相关的死亡率.
临床评分系统的适用性有限,往往低估了尾炎的可能性.

结论:

在免疫受损患者中诊断急性尾炎具有挑战性,标准评分系统不可靠.
腹部疼痛和高C反应蛋白 (CRP) 值得多学科评估和及时成像.
包括腹腔镜尾切除在内的外科手术对这一群体来说是安全的,也是可行的.
需要进一步的研究,以优化免疫功能低下个体的手术策略.

关键词:

血液学疾病血液学疾病白血球疾病白血球疾病疾病发病率疾病发病率死亡率死亡率死亡率中性发育不良症是如何发生的术后并发症术后并发症外科手术手术手术

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