Öz
Giriş
Akut apandisit, çocuklarda en sık görülen cerrahi acil durumlardan biridir. Morbidite ve mortaliteyi azaltmak için erken tanı kritik öneme sahiptir. Bu çalışmanın amacı, apandisit için öngörücü faktörleri belirlemek ve serum sodyum ile kan ve idrar keton düzeylerinin tanı değerini değerlendirmektir.
Yöntemler
Çalışmaya, akut karın ağrısı ile başvuran ve fizik muayenede apandisit şüphesi olan 18 yaş altı hastalar ileriye dönük olarak dahil edildi. Hastalar apandisit olanlar ve olmayanlar olarak gruplandırıldı; apandisit olanlar da kendi içinde akut ve komplike apandisit olarak ayrıldı. Demografik veriler, semptomlar, fizik muayene bulguları, semptom süresi, ameliyat öncesi laboratuvar sonuçları, kan ve idrar keton düzeyleri ve patoloji raporları kaydedildi.
Bulgular
Çalışmaya toplam 153 hasta dahil edildi [100 apandisit (51 komplike) ve 53 apandisit olmayan]. Apandisit grubunda lökosit, nötrofil, C-reaktif protein (CRP), kan ketonları [eğri altında kalan alan (AUC)=0,618] ve idrar ketonları (AUC=0,627) düzeyleri anlamlı derecede yüksekti (sırasıyla p<0,001, p<0,001, p=0,001, p=0,03, p=0,04). Semptom süresi <24 saat olan hastalarda apandisit grubunda lökosit (p=0,013), nötrofil (p=0,014) ve kan ketonu (p=0,035) anlamlı olarak yüksek bulundu. Semptom süresi >24 saat olan hastalarda ise apandisit grubunda lökosit (p=0,005), nötrofil (p=0,001), CRP (p=0,001) anlamlı olarak yüksek, sodyum (p=0,046) anlamlı olarak düşük bulundu.
Sonuç
Çalışmamızda apandisitli çocuklarda kan ve idrar keton düzeyleri anlamlı olarak yüksek bulundu. Kan keton düzeyi özellikle erken başvurularda faydalı olurken CRP artışı ve serum sodyum düşüklüğü hastaneye başvuru süresi uzadıkça daha anlamlı hale geldi.
Anahtar Kelimeler: Apandisit, çocuklar, acil, sodyum, keton
Kaynakça
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