Ulus Travma Acil Cerrahi Derg. 2021; 27(6): 654-661 | DOI: 10.14744/tjtes.2020.69195

Akut apandisit tanýsýný koymada ve ciddiyetini belirlemede hemogram parametre deðerlerinin rolü

Rýfat Peksöz¹, Bahattin Bayar^2
1Atatürk Üniversitesi Týp Fakültesi, Genel Cerrahi Anabilim Dalý, Erzurum
²Muþ Devlet Hastanesi, Genel Cerrahi Bölümü, Muþ

AMAÇ: Taný ve tedavideki tüm geliþmelere raðmen akut apandisitin tanýsýnýn ve ciddiyetinin deðerlendirilmesi halen zor olabilmektedir. Bu çalýþmada, birinci basamak saðlýk kuruluþlarýnda dahil rahatça ulaþýlabilen ve hýzlýca sonuçlanan hemogram parametrelerinin akut apandisitin tanýsý ve hastalýðýn ciddiyetini ortaya koymadaki etkinliðini deðerlendirmeyi amaçladýk.
GEREÇ VE YÖNTEM: Beþ yüz yirmi bir hasta geriye dönük incelendi. Çeþitli sebeplerle hemogram sonucunu etkileyen 53 hasta çalýþma dýþý býrakýldý. Hastalarýn yaþ, cinsiyet, hastanede yatýþ süresi, hemogram alt parametreleri ve histopatolojik sonuçlarý incelendi.
BULGULAR: Çalýþmada 468 hasta incelendi. Hastalarýn 279’u erkek %59.6, 189’u kadýn %40.4 olup tüm hastalarýn yaþ ortalamasý 33.37±13.05 yýl idi. Akut apandisit ön tanýsýyla ameliyat yapýlmayýp týbbi tedavi uygulanan 90 hasta (grup I), akut apandisit tanýsý alan nonkomplike 227 apandisit (grup II), komplike apandisit 151 (grup III) olarak üç grup halinde incelendi. beyaz kan hücresi (WBC), nötrofil, nötrofil-lenfosit oraný (NLR) deðerleri en az grup I’de, en fazla grup III’te görüldü. Gruplar arasýnda istatiksel olarak anlamlý fark saptandý (p<0.05). ortalama trombosit hacmi (MPV) deðerleri en fazla grup II’de en az grup III’de görüldü. Gruplar arasýnda istatiksel anlamlý fark saptanmadý (p>0.05).
TARTIÞMA: Akut apandisit karnýn en sýk görülen cerrahi hastalýðýdýr. Hemogram hemen tüm saðlýk kuruluþlarýnda kolay ulaþabilen, hýzlý sonuçlanan, maliyet etkin ve kabul edilebilir düzeylerde tanýsal etkinliði olan hastalýðýn tanýsýnda kullanýlabilen bir testtir. Hemogram parametrelerinden WBC, nötrofil, NLR akut apandisit tanýsý koymada ve þiddetini belirlemede fiziki muayene ve diðer taný yöntemlerine yardýmcý ve kullanýþlý deðiþkenlerdir. Ancak MPV deðerinin düþük tanýsal oranlarý ve çeliþkili sonuçlarý nedeniyle kullanýmýný önermiyoruz.

Anahtar Kelimeler: Akut apandisit, apandisitin ciddiyeti; lökosit; MPV; NLR; nötrofil.

---

The role of complete blood count parameters in diagnosing acute appendicitis and measuring the severity of inflammation

Rýfat Peksöz¹, Bahattin Bayar^2
1Depertmant of General Surgery, Atatürk University Faculty of Medicine, Erzurum-Turkey
²Departmant of General Surgery, Muþ State Hospital, Muþ-Turkey

BACKGROUND: The diagnosis and severity of acute appendicitis (AA) are still challenging despite all the improvements in diagnosis and treatment. This study aimed to evaluate the efficacy of complete blood count (CBC) parameters in diagnosing AA and measuring severity.
METHODS: Data of 521 patients were reviewed retrospectively. Fifty-three patients with CBC results influenced by various reasons were excluded from the study. Age, gender, length of stay, CBC parameters, and histopathological results were examined.
RESULTS: The study included 468 patients: 90 patients with a preliminary diagnosis of AA, not undergoing surgery but receiving medical treatment (Group I), 227 patients with uncomplicated appendicitis (Group II), and 151 patients with complicated appendicitis (Group III). Of the patients, 279 were male (59.6%) and 189 were female (40.4%). The mean age was 33.37±13.05 years. Groups I and III had the lowest and highest white blood cell (WBC), neutrophil, and neutrophil-to-lymphocyte ratio (NLR), respectively. There was a statistically significant difference between the groups (p<0.05). The highest and lowest mean platelet volume (MPV) values were in Groups II and III, respectively. There was no statistically significant difference between the groups (p>0.05).
CONCLUSION: AA is the most common cause of abdominal surgery. The CBC is a cost-effective and easily-accessible test with acceptable diagnostic accuracy. It provides fast results and can be used in the diagnosis of appendicitis. Neutrophil, WBC, and NLR are helpful and useful parameters for physical examination and other diagnostic methods in diagnosing AA and measuring severity. However, the use of MPV is not recommended as it has a low diagnostic rate and contradictory results.

Keywords: Acute appendicitis, leukocyte, neutrophil, neutrophil-to-lymphocyte ratio, mean platelet volume, severity of appendicitis.

---

ATIF KOPYALA