Analysis Of Influencing Factors Of Acute Appendicitis Perforation In Children

Objective Retrospective analysis of the influencing factors related to acute appendicitis perforation in children,and try to find out the relevant indicators indicating that acute appendicitis perforation in children.To provide a reference for the diagnosis of perforated acute appendicitis,so as to timely surgery and improve the prognosis.Methods Collecting the clinical data of all children with acute appendicitis aged 0-14 years from May 2016 to April 2018 in pediatric surgery,General Hospital of Ningxia Medical University.According to the intraoperative judgment,the appendix was divided into perforation group and unperforated group.Comparing the influence factor between the two groups: age,gender,nationality,onset season,nutritional status,time from onset to diagnosis,vomit,whether have peritonitis sign,used antibiotics or not before admission,maximum body temperature before admission,admission pulse,respiratory frequency on admission,White blood cell count(WBC),Neutrophil percentage(NEUT%),lymphocyte absolute value(ALC),hemoglobin(HGB),platelet count(PLT),mean platelet volume(MPV),platelet distribution width(PDW),ultrasound was used to detect peritoneal effusion,whether or not there is fecal stone in the appendix.Spss 21.0 was used for statistical analysis.Results There were 364 cases of acute appendicitis in children,of which 176 cases were perforated and 188 cases were not perforated.The perforating rate was 48.35%.The factors affecting perforation were age less than 6 years old,more than 24 hours from onset to diagnosis,peritonitis sign,no antibiotics before admission,maximum body temperaturebefore admission exceeding 38.5 ?,pulse increase on admission,higher WBC,increased percentage of neutrophils,hemoglobin reduction,higher platelet count,mean platelet volume decrease,reduction of platelet distribution width,abdominal effusion was detected by ultrasound,fecal stone in appendix(p < 0.05).Multivariate logistic regression analysis was carried out with the dependent variable of whether the appendix perforated or not and the independent variable of the above related factors.Six independent factors influencing acute appendicitis perforation in children were obtained by multivariate logistic regression analysis.The influence degree as follows:abdominal effusion was detected by ultrasound,more than24 hours from onset to diagnosis,fecal stone in appendix,maximum body temperature before admission exceeding 38.5 ?,increased percentage of neutrophils,age less than 6.Conclusion Abdominal effusion was detected by ultrasound,more than 24 hours from onset to diagnosis,fecal stone in appendix,maximum body temperature before admission exceeding 38.5 ?,higher neutrophil fraction,age less than 6 years old are independent risk factors for acute appendicitis perforation in children.