ÇOCUKLARDA AKUT, KOMPLİKE APANDİSİT VE KARIN AĞRISI GÖZLEM HASTALARINDA HEMOGRAM PARAMETRELERİ VE C-REAKTİF PROTEİN DEĞERLERİNİN KARŞILAŞTIRILMASI

Amaç: Dünyada akut karının yaygın nedenlerinden biri olarak kabul edilen apandisitin tanısı özellikle çocukluk çağında zordur ve başka hastalıklarla karışabilmektedir. Çalışmamızda akut, komplike apandisit tanısı alan ve karın ağrısı nedeniyle klinik izleme alınan hastaların ilk yatışlarında alınan c-reaktif protein (CRP) ve hemogram parametrelerinin analiz edilerek aralarındaki ilişkinin ortaya konulması amaçlanmıştır. Gereç ve Yöntem: Ocak 2016- Mayıs 2017 tarihleri arasında hastanemize karın ağrısı yakınması ile başvuran 573 çocuk hasta geriye dönük olarak tarandı. Hastalar karın ağrısı nedeniyle takip edilenler, akut ve komplike apandisit olanlar olmak üzere üç gruba ayrıldı. Tüm hastaların demografik verileri, CRP, hemogram parametreleri ve bundan türetilen oranlar kaydedildi. Bulgular: NLO, WBC/MPV, CRP/MPV, PLO ve MPV/L değerleri apendektomi yapılan hastalarda karın ağrısı gözlem grubundan daha yüksek çıkmıştır (p<0.001). Hb, MCV, MPV, htc, platelet sayıları gruplara göre istatistiksel olarak anlamlı farklı değildi (p>0.05) Sonuç: NLO, WBC/MPV, CRP/MPV, PLO ve MPV/L değerlerinin apendektomi yapılan hastalarda daha yüksek çıkması nedeniyle operasyona karar vermede ya da karın ağrısı gözlemleri belirlemede bu parametrelerin tanıyı destekleyeceği kanaatindeyiz.

Anahtar Kelimeler:

Apendektomi, çocukluk çağı, crp, hemogram parametreleri

Comparison of the Hemogram Parameters and C-reactive Protein Values in Patients with Acute, Complicated Appendicitis and Non-spesific Abdominal Pain in Children

Aim: Appendicitis, accepted as one of the common causes of acute abdominal pain in the world, is difficultto diagnose especially in the childhood period and could be mixed up with other diseases. This study aimsto analyze patients’ C - reactive protein (CRP) and Hemogram parameters at first hospitalization and identifythe relationship between them in patients who were diagnosed with acute, complicated appendicitis andwere under clinical observation due to non-specific abdominal pain.Material and Methods: 573 pediatric patients who applied to our hospital with the complaint of abdominalpain between January 2016 and May 2017 were screened retrospectively. The patients were divided intothree groups as those who were under clinical observation due to non-specific abdominal pain and thosewho had acute appendicitis and complicated appendicitis. Demographic data, CRP, Hemogram parameters,and the proportions derived from these were recorded for all the patients.Results: Compared to the observation non-specific abdominal pain group, NLO, WBC/MPV, CRP/MPV, PLOand MPV/L values were found to be higher in the patient group that underwent appendectomy (p<0.001).Hb, MCV, MPV, HTC, platelet numbers were not statistically significant according to the groups (p>0.05).Conclusion: As the NLO, WBC/MPV, CRP/MPV, PLO and MPV/L values were found to be higher in the groupthat underwent appendectomy, we believe that these parameters could support diagnosis in terms of thedecision to perform surgery or identification of non-specific abdominal pain observations.

Keywords:

Appendectomy, childhood, crp, hemogram parameters,

PDF

___

1. McGowan DR, Sims HM, Zia K, Uheba M, Shaikh IA. The value of biochemical markers in predicting a perforation in acute appendicitis. ANZ J Surg. 2013;83:79–83. 2. K. McCabe, F. E. Babl, and S. Dalton. “Paediatric Research in Emergency Departments International Collaborative (PREDICT). Management of children with possible appendicitis: a survey of emergency physicians in Australia and New Zealand.” Emergency Medicine Australasia. 2014;26(5):481–86. 3. Keskek M, Tez M, Yoldas O, Acar A, Akgul O, Gocmen E, et al. Receiver operating characteristic analysis of leukocyte counts in operations for suspected appendicitis. Am J Emerg Med. 2008;26:769–72. 4. Jess P, Bjerregaard B, Brynitz S, Holst-Christensen J, Kalaja E, Lund-Kristensen J. Acute appendicitis. Prospective trial concerning diagnostic accuracy and complications. Am J Surg. 1981;141:232–4. 5. Arnbjörnsson E. Small intestinal obstruction after appenectomy: an avoidable complication? Curr Surg. 1984;41:354-7. 6. Shafi SM, Afsheen M, Reshi FA. Total leucocyte count, C-reactive protein and neutrophil count: diagnostic aid in acute appendicitis. Saudi J Gastroenterol. 2009;15:117–20. 7. Albayrak Y, Albayrak A, Albayrak F, Yildirim R, Aylu B, Uyanik A, et al. Mean platelet volume: a new predictor in confirming acute appendicitis diagnosis. ClinApplThrombHemost. 2011;17:362–6. 8. Goodman DA, Goodman CB, Monk JS. Use of the neutrophil: lymphocyte ratio in the diagnosis of appendicitis. AmSurg. 1995;61:257–9. 9. Martin JF, Trowbridge EA, Salmon G, Plumb J. The biological significance of platelet volume: its relationship to bleeding time, platelet thromboxane B2 production and megakaryocyte nuclear DNA concentration. ThrombRes. 1983;32:443–60. 10. Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? CurrPharmDes. 2011;17:47–58.