炎性反应在不同病理类型急性阑尾炎围术期的比较

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Abstract Objective To investigate the changes of perioperative inflammatory response in patients with different pathological types of acute appendicitis and its clinical significance for preoperative diagnosis. Methods The perioperative clinical data of 126 patients with acute appendicitis in the Aerospace Center Hospital from June 2015 to January 2017 was analyzed retrospectively. The inflammatory response indicators of patients with acute simple appendicitis (ASA, group A), acute purulent appendicitis (APA, group B) and acute gangrenous appendicitis (AGA, group C) were compared and analyzed before operation and 1, 3, 5 d after operation. The inflammatory response indicators included the highest body temperature (HBT), peripheral white blood count (WBC), neutrophil percentage (NE%), peripheral blood neutrophil / lymphatic ratio (NLR), high sensitivity C reactive protein (hs-CRP) and procalcitonin (PCT). Results The indicators of postoperative inflammatory reaction of the three groups decreased gradually with the passage of time. The inflammatory indicators at 1, 3, 5 d after operation were significantly lower than those before operation, the inflammatory indicators at 3, 5 d after operation were lower than those at 1 d after operation, which at 5 d after operation were lower than those at 3 d after operation, the differences were statistically significant (P ＜ 0.05). Before operation, HBT, WBC, hs-CRP, PCT of group C were higher than those of group A and group B (P ＜ 0.05). The inflammatory indicators had no statistically significant differences between group A and group B at 1, 3, 5 d after operation (P ＞ 0.05). The WBC, NE%, hs-CRP, PCT and NLR in group C were significantly higher than those in group A and group B at 1, 5 d after operation, with statistically significant differences (P ＜ 0.05); the WBC, NLR, hs-CRP and PCT in group C were significantly higher than those in group A and group B at 3 d after operation, with statistically significant differences (P ＜ 0.05). Conclusion The indicators of inflammatory response play a very important role in the diagnosis of acute appendicitis and it is helpful for diagnosing AGA before operation, so as to determine the conditions of acute appendicitis and deal with the condition promptly. The inflammatory response of patients with AGA has a relatively slow recovery and a higher incidence of infection-related complications.

Key words： Inflammatory response Pathological type Acute appendicitis Perioperative period

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	KANG Chunbo1 LI Wenqiang1 ZHENG Jianwei1 WANG Dezhong1 LIN Dapeng1 CHEN Xiufeng1 LIU Xuekai2 QU Jun1▲

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KANG Chunbo1 LI Wenqiang1 ZHENG Jianwei1 WANG Dezhong1 LIN Dapeng1 CHEN Xiufeng1 LIU Xuekai2 QU Jun1▲. Comparison of inflammatory response in the perioperative period of acute appendicitis with different pathological types[J]. 中国医药导报, 2019, 16(20): 152-155.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I20/152

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