高胆红素血症在急性化脓坏疽性阑尾炎中的预测价值

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Abstract Objective To evaluate the predictive value of hyperbilirubinemia in the diagnosis of acute purulent gangrenous appendicitis.Methods A total of 226 patients with acute appendicitis who were admitted to our hospital from January 2010 to January 2018 were selected as research subjects,serum total bilirubin(TBil),C-reactive protein(CRP)and white blood cell count(WBC)were detected in all patients before operation,the patients were divided into simple appendicitis group (51 cases),acute pyogenic gangrenous appendicitis group (129 cases)and perforating appendicitis group (46 cases)according to postoperative pathology,the incidence of hyperbilirubinemia,serum bilirubin,CRP and WBC levels were recorded,the sensitivity and specificity of acute pyogenic gangrenous appendicitis were predicted by Alavrdo score.Results The incidence of hyperbilirubinemia,postoperative complications,Alvardo score,WBC,TBil and CRP levels in simple appendicitis group were lower than those in pyogenic gangrenous appendicitis group and perforating appendicitis group(P＜0.05),the duration of abdominal pain and postoperative hospitalization were shorter than those of pyogenic gangrenous appendicitis group and perforating appendicitis group (P＜0.05);There was no significant difference in the incidence of hyperbilirubinemia and postoperative complications between pyogenic gangrenous appendicitis group and perforating appendicitis group(P＞0.05);The duration of abdominal pain and postoperative hospitalization in pyogenic gangrenous appendicitis group were shorter than those in perforating appendicitis group (P＜0.05),alvardo scores,WBC,TBil and CRP levels were lower than those in the perforated appendicitis group(P＜0.05).The sensitivity,specificity,positive predictive value and negative predictive value of acute pyogenic gangrenous appendicitis were 89.5%,91.6%,85.7%and 93.8%respectively,when serum bilirubin level＞21.3 mol/L,sensitivity and specificity were significantly higher than those of WBC,CRP and Alavrdo scores(P＜0.05).Conclusion Hyperbilirubinemia has better predictive value in the diagnosis of acute suppurative gangrenous appendicitis.

Key words： Acute appendicitis Hyperbilirubinaemia Sensitivity Specificity

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	Articles by authors
	TAO Hong-fa
	ZHAO Kun
	XIAO Yong
	ZHANG Chao
	YE Yuan-li
	REN Peng-zhen
	HE Xiao-yu

Cite this article:

TAO Hong-fa,ZHAO Kun,XIAO Yong, et al. Predictive value of hyperbilirubinemia in acute suppurative gangrenous appendicitis[J]. 中国当代医药, 2018, 25(29): 33-36.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2018/V25/I29/33

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