分诊与急性阑尾炎预后的关系

  目的  探讨急性阑尾炎患者的分诊是否对其预后产生影响。  方法  回顾性分析98例出院诊断为急性阑尾炎患者的分诊情况及其术前检查情况、病理结果及预后等。  结果  首诊于外科的急性阑尾炎患者为69例(70.41%), 不同科室就诊患者起病时间不同, 差异有统计学意义(P=0.0001)。全部患者均诉有腹痛, 40例(40.82%)有典型的转移性右下腹痛; 全部患者查体均有右下腹压痛, 40例(40.82%)有反跳痛; 82例(83.67%)患者白细胞升高。术前准备时间以外科最长, 其次为内科及妇产科, 但三个科室的术前准备时间差异无统计学意义(P=0.723)。首诊于三个科室的患者白细胞计数差异无统计学意义(P=0.653)。并发腹膜炎患者(28例)和无腹膜炎患者(70例)的白细胞计数差异无统计学意义(P=0.648)。首诊科室的不同, 并不会导致患者腹膜炎发生率的不同(P=0.542)。  结论  首诊科室的不同不会影响阑尾炎患者的预后, 而预后与术前时间、首诊科室及白细胞数目的关系仍有待更大样本的研究。

Relationship between Triage and the Prognosis of Acute Appendicitis

Objective To investigate whether the triage mode influence the prognosis of acute appendicitis. Methods We retrospectively analyzed the triage conditions of 98 appendicitis patients and their prognosticinformation. Meanwhile, their preoperative examination results and pathology were also analyzed. Results Sixty-nine patients （70. 41% ） with acute abdominal pain were triaged at the surgical admission room. The diseaseonset time significantly differed among patients triaged at different admission rooms （P = 0. 0001）. All patientshad abdominal pain, and 40 （40. 82% ） of them had migrating right low abdominal pain. All patients had rightlow abdominal tenderness, and 40 （40. 82% ） of them had rebound tenderness. Eighty-two patients （83. 67% ）had increased white blood cell （ WBC） count. Patients admitted to the surgery department had the longest preoperative preparation time, followed by those in the department of internal medicine and department of obstetricsand gynecology, although the difference was not significant （P =0.723）. The WBC count was not significantlydifferent among patients admitted to the three departments （P = 0. 653）. In addition,it was not significantly dif-ferent between 28 patients complicated with peritonitis and 70 patients without peritonitis （P = 0. 648）. The incidence of peritonitis in patients admitted to different departments was not significantly different （P=0. 542）. Conclusions The departments where the patients visit do not affect the prognosis of acute appendicitis. However,the relations of prognosis with the preoperative preparation time,triage,and WBC count require more trialswith larger sample sizes.