评估 C 反应蛋白在降低阑尾切除术失败率中的作用

Clement Odion, J. Kpolugbo, Andrew E. Dongo, F. Ogbetere
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摘要

背景:急性阑尾炎是腹部常见的外科疾病:急性阑尾炎是腹部常见的外科疾病。然而,由于诊断困难,阑尾切除术的阴性率很高。本研究旨在评估 C 反应蛋白(CRP)在提高急性阑尾炎诊断准确性方面的作用,从而降低阑尾切除术的阴性率。材料和方法:该研究是一项以医院为基础的横断面研究,针对 66 名临床诊断为急性阑尾炎后进行阑尾切除术的患者。所有入选患者在术前都采集了 CRP 样本。 阑尾切除术后,阑尾被送去做组织学检查。数据收集采用表格形式。所有统计分析均使用 IBM 社会科学统计软件包(SPSS)第 21 版进行。在 95% 的置信水平下,P 值小于 0.05 即为显著。结果切除的阑尾中有 13 个组织病理学检查结果正常,阑尾切除阴性率为 19.7%。术前 CRP 的诊断准确性、敏感性、特异性和阳性预测值分别为 80%、79%、85% 和 95%。结论CRP 升高是诊断急性阑尾炎的有效辅助指标。对 CRP 正常的患者推迟手术可能会降低阑尾切除术阴性的发生率。
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Evaluating the Role of C-reactive Protein in Reducing the Rate of Negative Appendicectomies
Background: Acute appendicitis is a common surgical condition of the abdomen. However, diagnostic difficulties may arise, resulting in high rate of negative appendicectomies. This study aimed to assess the role of C-reactive protein (CRP) in improving the                                  accuracy of diagnosis of acute appendicitis and thus reducing the rate of negative appendicectomies. Materials and Method: The study was a cross-sectional, hospital-based study carried out on 66 patients who had appendicectomy following a clinical diagnosis of acute appendicitis. Samples for CRP were collected from all recruited patients preoperatively.  Following appendicectomy, the appendix was sent for histology. A proforma was used to collect data. All the statistical analyses were performed using IBM statistics package for social sciences (SPSS) version 21. At 95% confidence level, p-values less than 0.05 were considered significant. Results: Thirteen (13) of the appendices removed had normal histopathologic examination, giving a negative appendicectomy rate of 19.7%. The diagnostic accuracy, sensitivity, specificity and positive predictive value for preoperative CRP were 80%, 79%, 85% and 95% respectively. Conclusion: An elevated level of  CRP is a useful aid for the diagnosis of acute appendicitis. Deferring surgery in patients with normal CRP would likely decrease the incidence of negative appendicectomies.
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