Ulus Travma Acil Cerrahi Derg. 2022; 28(7): 960-966 | DOI: 10.14744/tjtes.2021.83364

Akut apandisitte perforasyonu öngörmede kullanýlan laboratuvar belirteçleri

Mehmet Patmano, Durmuþ Ali Çetin, Tufan Gümüþ
Þanlýurfa Eðitim ve Araþtýrma Hastanesi, Genel Cerrahi Kliniði, Þanlýurfa

AMAÇ: Bu çalýþmada, akut apandisit tanýsýnda kullanýlan laboratuvar belirteçlerin deðerlendirmesini yapmak ve perfore akut apandisiti öngörmede kullanýlabilecek parametreleri sunmayý amaçladýk.
GEREÇ VE YÖNTEM: Eylül 2018 ile Mart 2020 tarihleri arasýnda kliniðimizde apendektomi yapýlan olgular geriye dönük olarak deðerlendirildi. Ça-lýþma kriterlerine uyan toplam 530 hasta çalýþmaya alýndý. Hastalar intraoperatif perforasyon varlýðýna göre iki gruba ayrýldý. Non-komplike apandisit hastalarý Grup 1 ve perfore apandisit hastalarý Grup 2 oluþturdu. Hastalarýn demografik, klinik ve laboratuvar özellikleri karþýlaþtýrýldý. BULGULAR: Non-komplike hastalardan oluþan Grup 1’de hasta sayýsý 443 (%83.6), perfore apandisit hastalarýndan oluþan Grup 2’de hasta sayýsý 87 (%16.4) idi. Normal apandisit grubu hastalarýn ortalama yaþý 29.90±10.51 yýl, perfore apandisit grubu hastalarýn ortalama yaþý 36.32±14.58 yýl idi. Normal apandisit grubunda hastalarýn 257’si (%58) erkek, 186’sý (%42) kadýn, perfore apandisit grubunda 38’i (%43.7) erkek, 49’u (%56.3) kadýn idi. Perfore apandisit grubunda WBC deðeri16.19±4.71 (p<0.001), CRP deðeri 146.28±113.59 (p<0.001), total bilirubin deðeri 0.71±0.36 (p<0.001), NLO perfore apandisit grubunda 10.85±6.25 (p<0.001) olarak bulundu.
TARTIÞMA: Akut apandisit hastalarýna acil servislerde rutin bakýlan hýzlý ve kolay ulaþýlabilir kan tetkikindeki belirteçlerle yapýlan bu çalýþma ile elde edilen WBC, total biluribin, CRP ve NLO deðerlerinin perforasyonu öngörmede katký saðlayabileceði kanaatindeyiz.

Anahtar Kelimeler: Beyaz küre, bilirubin, C-reaktif protein; nötrofil lenfosit oraný; öngörücü faktörler; perfore apandisit.

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Laboratory markers used in the prediction of perforation in acute appendicitis

Mehmet Patmano, Durmuþ Ali Çetin, Tufan Gümüþ
Department of General Surgery, Þanlýurfa Training and Research Hospital, Þanlýurfa-Türkiye

BACKGROUND: In this study, we aimed to evaluate the laboratory markers used in the diagnosis of acute appendicitis (AA) and present the parameters that can be used to predict acute perforated appendicitis.
METHODS: The cases who underwent an appendectomy in our clinic between September 2018 and March 2020 were evaluated retrospectively. A total of 530 patients who met the study criteria were included in the study. Patients were divided into two groups according to the presence of an intraoperative perforation. Non-complicated appendicitis patients formed Group-1, and perforated appendicitis patients formed Group-2. The demographic, clinical, and laboratory characteristics of the patients were compared.
RESULTS: The number of non-complicated patients in Group 1 was 443, while there were 87 (16.4%) patients in Group 2 who had perforated appendicitis. The mean age of the patients in the normal appendicitis group was 29.90±10.51 years, and the mean age of the patients in the perforated appendicitis group was 36.32±14.58 years. In the normal appendicitis group, 257 (58%) of the patients were male, 186 (42%) were female, while in the perforated appendicitis group, 38 (43.7%) were male, 49 (56.3%) were female. In the perfo-rated appendicitis group, white blood cell (WBC) value was 16.19±4.71 (p<0.001), C-reactive protein (CRP) value was 146.28±113.59 (p<0.001), total bilirubin value was 0.71±0.36 (p<0.001), and neutrophil-lymphocyte ratio (NLR) was 10.85±6.25 (p<0.001).
CONCLUSION: We believe that the WBC, total bilirubin, CRP, and NLR values obtained within this study, which is tested in the rapid and easily accessible blood tests in routine examinations that can contribute to the prediction of perforation.

Keywords: Bilirubin, C-reactive protein, neutrophil-lymphocyte ratio; perforated appendicitis; predictive factors; white blood cell.

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ATIF KOPYALA