milmedВоенная медицинаMilitary Medicine2074-5044Белорусский государственный медицинский университет10.51922/2074-5044.2026.3.18milmed-350Research ArticleОРИГИНАЛЬНЫЕ НАУЧНЫЕ ПУБЛИКАЦИИ. Лечебно-профилактические вопросыORIGINAL SCIENTIFIC PUBLICATIONS. Medical and preventive questionsКлинико-лабораторные предикторы деструктивных форм острого аппендицита: данные проспективного исследованияClinical and laboratory predictors of destructive forms of acute appendicitis: data from a prospective studyГринкевичМ. В.GrinkevichM. V.

Гомель

Gomel

ЧерняковаЮ. В.ChernyakovaYu. V.

Гомель

Gomel

КутенкоЯ. А.KutsenkoYa. A.

Гомель

Gomel

УО «Гомельский государственный медицинский университет»БеларусьGomel State Medical UniversityBelarus202601092026031821Copyright © Гринкевич М.В., Чернякова Ю.В., Кутенко Я.А., 20262026Гринкевич М.В., Чернякова Ю.В., Кутенко Я.А.Grinkevich M.V., Chernyakova Y.V., Kutsenko Y.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://milmed.ejournal.by/jour/article/view/350

Исследование посвящено анализу значимых клинико-лабораторных предикторов развития деструктивных форм острого аппендицита (ОА). В проспективное исследование включены 100 пациентов с верифицированным ОА (58 женщин, 42 мужчины, средний возраст 41,2 ± 16,3 года). У 34 пациентов интраоперационно диагностированы гангренозные или перфоративные формы. Проведен сравнительный анализ клинических и лабораторных показателей между группами с деструктивными и недеструктивными формами. Пациенты с деструктивными формами имели достоверно более длительный анамнез заболевания до госпитализации (34,5 ± 12,8 часа против 14,2 ± 6,5 часа в группе с недеструктивными формами, p < 0,05), возраст старше 50 лет (64,7 % против 31,8 %, p < 0,05), более высокий уровень лейкоцитоза (17,4 ± 3,1×109/л против 12,1 ± 2,8×109/л, p < 0,05) и С-реактивного белка (189,5 ± 65,2 мг/л против 52,3 ± 28,7 мг/л, p < 0,05). В группе с деструкцией чаще выявлялся прокальцитонин >0,5 нг/мл (73,5 % против 15,2 %, p < 0,05). Комбинация трех и более факторов (анамнез >24 ч, возраст >50 лет, лейкоцитоз >15×109/л, СРБ >150 мг/л) ассоциировалась с высоким (87,5 %) риском развития гангренозного или перфоративного аппендицита. Полученные данные демонстрируют, что комплексная оценка простых клинико-лабораторных параметров позволяет с высокой точностью прогнозировать риск деструктивных форм ОА и способствует своевременному выбору адекватной хирургической тактики.

This study analyzes significant clinical and laboratory predictors of destructive forms of acute appendicitis (AA). A prospective study included 100 patients with confirmed AA (58 women, 42 men, mean age ± 16.3 years). In 34 patients, gangrenous or perforated forms were diagnosed intraoperatively. A comparative analysis of clinical and laboratory parameters was performed between groups with destructive and non-destructive forms. Patients with destructive forms had a significantly longer history of the disease before hospitalization (34.5 ± 12.8 hours vs. 14.2 ± 6.5 hours in the non-destructive group, p < 0.05), age over 50 years (64.7 % vs. 31.8 %, p < 0.05), higher levels of leukocytosis (17.4 ± 3.1×109/L vs. 12.1 ± 2.8×109/L, p < 0.05), and C-reactive protein (189.5 ± 65.2 mg/L vs. 52.3 ± 28.7 mg/L, p < 0.05). In the group with destructive forms, procalcitonin >0.5 ng/mL was detected more frequently (73.5 % vs. 15.2 %, p < 0.05). The combination of three or more factors (history >24 h, age >50 years, leukocytosis >15×109/L, CRP >150 mg/L) was associated with a high (87.5 %) risk of developing gangrenous or perforated appendicitis. The obtained data demonstrate that a comprehensive assessment of simple clinical and laboratory parameters allows for highly accurate prediction of the risk of destructive forms of AA and contributes to the timely selection of an adequate surgical strategy.

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The authors declare that there are no conflicts of interest present.