文章：

血液病患者阑尾炎手术治疗相关风险

Risks Associated with Surgical Treatment for Appendicitis in Hematologic Patients

原文发布日期：19 October 2023

DOI: 10.3390/cancers15205049

类型: Article

开放获取: 是

英文摘要：

Appendicitis is a prevalent surgical emergency. Although appendectomy has traditionally been the go-to treatment, recent studies suggest antibiotics can be equally effective for uncomplicated cases. However, evidence is scant regarding patients with hematologic disorders. This study delves into the surgical risks tied to appendicitis in patients with underlying hematologic conditions. A retrospective analysis was carried out on patients diagnosed with appendicitis and hematologic disorders from January 2000 to June 2021. Patients were pinpointed using ICD-10 diagnostic codes, and surgical procedures were identified based on the hospital’s surgical fee codes. Hematologic conditions were sorted into risk levels, and patient treatments were scrutinized. Among the 131 initially identified patients, 89 were included in the study. Out of these, 75 underwent surgical procedures, while 14 received non-surgical treatments. The surgical group displayed better preoperative laboratory outcomes. Clinical characteristics, hematologic disease risk, and severity of appendicitis appeared not to be related to surgical complications. Patients without surgical complications showed improvement in preoperative absolute neutrophil count (ANC) and platelet counts. Lower preoperative ANCs and platelet counts were associated with extended hospital stays. For patients with hematologic disorders diagnosed with appendicitis, thorough preoperative laboratory evaluations followed by minimally invasive appendectomy appear to be a safe route without heightening the risk of severe complications compared to non-surgical management.

摘要翻译： 

阑尾炎是一种常见的外科急症。虽然阑尾切除术历来是首选治疗方法，但近期研究表明抗生素治疗对非复杂性病例同样有效。然而，关于血液系统疾病患者的治疗证据尚不充分。本研究深入探讨了基础血液系统疾病患者罹患阑尾炎时面临的手术风险。研究对2000年1月至2021年6月期间诊断为阑尾炎合并血液系统疾病的患者进行了回顾性分析。通过ICD-10诊断代码确定患者，并依据医院手术收费代码识别手术操作。血液系统疾病按风险等级分类，并对患者治疗方案进行详细审查。在初步确定的131例患者中，最终纳入89例进行研究。其中75例接受手术治疗，14例接受非手术治疗。手术组患者术前实验室指标更优。临床特征、血液疾病风险等级及阑尾炎严重程度与手术并发症未见明显关联。未出现手术并发症的患者术前中性粒细胞绝对计数（ANC）和血小板计数均有改善。较低的术前ANC和血小板计数与住院时间延长相关。对于确诊阑尾炎的血液系统疾病患者，通过全面的术前实验室评估后实施微创阑尾切除术，相较于非手术治疗并未增加严重并发症风险，是一种安全的治疗路径。

原文链接：

Risks Associated with Surgical Treatment for Appendicitis in Hematologic Patients