Routine Urinalysis in Patients with Acute Appendicitis

闌尾炎病人的尿液檢查發現

魏晉三(Chin-San Wei) ； 吳漢屏(Han-Ping Wu) ； 張玉君(Yu-Jun Chang)

《中華民國急救加護醫學會雜誌》 18卷2期 (2007/06) Pp. 71-78

https://doi.org/10.30018/JECCM.200706.0003

摘要

背景：急性闌尾炎是急性腹症手術中最常見的原因，但由於急性闌尾炎的不易診斷，使得誤診率及闌尾破裂率居高不下，本研究欲探究急性闌尾炎與異常尿液分析檢驗的相關性，以早期正確診斷急性闌尾炎並區别是否為破裂性闌尾炎。
方法：本研究採回溯性分析自2002年10月至2004年10月之中，714位於臨床診斷疑似急性闌尾炎而接受手術之病患，所有病患皆於術前作尿液分析檢驗，其中包括333位男性及381位女性，而根據病理切片報告，將所有病患分為三組，分别是正常闌尾，單純性闌尾炎（未破）及破裂性闌尾炎。
结果：我們依據病患的尿液分析檢驗報告，統計分析得到以下具有顯著意義的结果：急性闌尾炎的病患較正常闌尾的病患有較高百分比的陽性酮體反應，較高的比重及較低之酸鹼值。另外，破裂性闌尾炎的病患比單純性闌尾炎的病患有较高百分比的陽性酮體反應，陽性潛血反應，陽性白血球酯酶反應，較高的比重，較高的尿液白血球（大於五顆），較多的尿液红血球及較低之酸鹼值。
结論：利用例行性的尿液分析檢驗可助於區别是否為單純性闌尾炎或破裂性闌尾炎，亦有助於臨床醫師了解急性闌尾炎病患的尿液分析結果。

關鍵字

尿液分析 ； 發現 ； 急性闌尾炎

並列摘要

Objective: Acute appendicitis is the most common abdominal surgical emergency. The correlation between abnormal urinalysis and appendicitis is still unclear. Therefore, we aimed to determine whether routine urinalysis may serve as a tool to discriminate between acute appendicitis and perforated appendicitis.
Methods: We analyzed retrospectively 714 patients with clinically suspected acute appendicitis who underwent urinalysis followed by appendectomy at the Changhua Christian Hospital, Taiwan, from 2003 to 2005. Urine test strip analysis was analyzed with the automated URISYS 2400.
Results: Patients with acute appendicitis had a significantly higher percentage of positive urine ketone bodies (p=0.019), higher specific gravity (p=0.004) and lower urine pH (p=0.005) than patients with normal appendices. In addition, patients with perforated appendicitis had a significantly higher percentage of positive ketone bodies (p=0.003), positive occult blood (p=0.024), positive leukocyte esterase (p=0.003), higher positive white blood cell count (greater than 5/high power field) (p=0.010), higher specific gravity (p=0.003), higher red blood cell counts (p=0.002) and lower pH (p=0.002) than patients with non-perforated (simple) appendicitis.
Conclusion: Routine urinalysis may show differences in findings between simple and perforated appendicitis. Clinically, we believe these urine parameters may aid clinicians in decision making for patients with suspected appendicitis.

並列關鍵字

urinalysis ； finding ； acute appendicitis