关键词: 急性阑尾炎, 诊断

Abstract: Objective To analyze the best combination of clinical and laboratory examinations for the diagnosis of acute appendicitis. Methods The data of 146 patients with acute appendicitis admitted to the emergency department of our hospital from July 2018 to June 2019 were collected for a retrospective study, and another 129 patients with acute abdomen as controls. Clinical parameters were recorded and analyzed by logistic regression,including nausea, vomiting, diarrhea, dysuria, signs of local peritonitis and pain migration; laboratory parameters： C-reactive protein （CRP）, complete blood count and urine test. Results Frequent vomiting, no change in appetite, diarrhea, and dysuria were not rare manifestations of acute appendicitis. Univariate logistic regression confirmed that WBC and negative urine test results were statistically significant predictors of acute appendicitis. Multiple regression analysis showed that vomiting （once or twice）, diarrhea, positive symptoms of local peritonitis, white blood cell count and negative urine test were significant predictors of AA. For simple, purulent, and gangrenous acute appendicitis, the predictability of a negative urine test decreases. Conclusion Compared with acute abdomen, no frequent vomiting, no diarrhea, no dysuria, localized peritonitis, elevated WBC, and negative urine test are important indicators for the diagnosis and differential diagnosis of acute appendicitis.

Key words: acute appendicitis, diagnosis, laboratory examination