高胆红素血症在急性阑尾炎临床诊断中的价值

Value of hyperbilirubinemia in clinic diagnose of acute appendicitis

目的:探讨高胆红素血症在急性阑尾炎诊断中的价值。方法:本院2008年1月～2009年12月收治115例阑尾炎,其中急性阑尾炎110例,正常阑尾5例,所有病例术前均经实验室指标及腹部B超检查。术前均行血清胆红素和肝功能检查并对比术后病理,作回顾性分析。结果:在坏疽或穿孔性阑尾炎病例中血浆胆红素水平较单纯性阑尾炎明显升高。特异性和敏感性分别为100%,71.8%。大多数患者谷草转氨酶(AST)为正常或轻度升高。结论:血浆胆红素升高是确诊急性阑尾炎的一个很好指标。血浆胆红素列入急性阑尾炎术前常规实验室检查指标,也有利于临床不典型阑尾炎的明确诊断,及避免延误手术治疗时机。

Objective：To determine the role and predictive value of hyperbilirubinemia in diagnosing acute appendicitis（AA）.Methods：Clinic data of 110 cases underwent emergency appendicectomy from January 2008 to December 2009 were analyzed retrospectively in present study.All patients with AA were tested by laboratory investigations and abdominal ultrasonograhy.Before surgery,patient＇s blood were also collected for serum bilirubin test and other liver function assay.Results：In patients with gangrenous or perforated appendix,plasma bilirubin was found to be higher than patients with simple suppurative AA.The specificity,and sensitivity was 100% and 71.8%,respectively.The hepatic enzymes were either normal or slightly higher in most of the cases.Conclusions：It was found in our study that plasma bilirubin（without severe abnormalities in hepatic enzymes）is good indicator of AA.It is helpful in the diagnosis of atypical AA,and can avoid treatment delay.