2026 年第 3 期 第 21 卷

不同病理类型急性阑尾炎患者的特征和相关因素分析

Analysis of clinical characteristics and related factors in patients with acute appendicitis of different pathological types

作者：张玲1訾金花2陈明3张伟4

英文作者：Zhang Ling1 Zi Jinhua2 Chen Ming3 Zhang Wei4

单位：1山东省临沂市人民医院小儿骨伤骨肿瘤科，临沂276000；2山东省临沂市人民医院创伤骨科二病区，临沂276000；3山东省临沂市人民医院综合骨科，临沂276000；4山东省临沂市人民医院运动医学与保膝外科，临沂276000

英文单位：1Department of Pediatric Orthopedics and Bone Tumor Surgery Linyi People′s Hospital Shandong Province Linyi 276000 China； 2Second Ward of Department of Trauma Orthopedics Linyi People′s Hospital Shandong Province Linyi 276000 China; 3Department of General Orthopedics Linyi People′s Hospital Shandong Province Linyi 276000 China; 4Department of Sports Medicine and Knee Preservation Surgery Linyi People′s Hospital Shandong Province Linyi 276000 China

关键词：急性阑尾炎；病理类型；病因学

英文关键词：Acuteappendicitis;Pathologicaltypes;Etiology

• 摘要：

• 目的 探讨不同病理类型急性阑尾炎患者的特征和相关因素。方法 回顾性分析山东省临沂市人民医院2018年1月至2023年12月诊断为急性阑尾炎并行手术治疗的2 482例患者的临床资料。收集患者的年龄、性别、病理类型、合并基础疾病情况、发热程度、阑尾位置、阑尾炎病史等相关资料。采用多因素Logistic回归方法分析不同病理类型急性阑尾炎患者的相关区别因素。结果 2 482例患者年龄（41±17）岁、范围14～99岁。多因素Logistic回归方法结果显示：急性单纯性阑尾炎与坏疽性/穿孔性阑尾炎相比较，年龄小及阑尾长度短时更可能表现为急性单纯性阑尾炎，有合并疾病、无发热及有阑尾炎病史时更可能表现为坏疽性/穿孔性阑尾炎（比值比=0.974、0.003、13.435、12.945、3.665，均P<0.05）。急性化脓性阑尾炎与坏疽性/穿孔性阑尾炎相比较，阑尾长度短及特定阑尾位置（回肠后位、回肠前位、盲肠后位、盲肠外位）时更可能表现为急性化脓性阑尾炎，有合并疾病、无发热及特定阑尾位置（盆位）时更可能表现为坏疽性/穿孔性阑尾炎（比值比=0.095、<0.001、0.001、0.001、0.004、2.765、3.978、202.520，均P<0.05）。结论 年龄小及阑尾长度短时更可能表现为急性单纯性阑尾炎，有合并疾病即使无发热也可能表现为坏疽性/穿孔性阑尾炎。

• Objective To investigate the clinical characteristics and related factors in patients with acute appendicitis of different pathological types. Methods A retrospective analysis was conducted on the clinical data of 2 482 patients diagnosed with acute appendicitis and undergoing surgical treatment in Linyi People′s Hospital, Shandong Province from January 2018 to December 2023. Relevant data including age, gender, pathological type, complicated underlying diseases, fever degree, appendiceal location and history of appendicitis were collected. Multivariate Logistic regression analysis was used to identify the differential related factors in patients with acute appendicitis of different pathological types. Results The mean age of the 2 482 patients was (41±17) years old, ranging from 14 to 99 years old. Multivariate Logistic regression analysis showed that compared with gangrenous/perforated appendicitis, younger age and shorter appendiceal length were more likely to be associated with acute simple appendicitis, while complicated underlying diseases, absence of fever and history of appendicitis were more likely to be associated with gangrenous/perforated appendicitis (odds ratios=0.974, 0.003, 13.435, 12.945, 3.665, all P<0.05). Compared with gangrenous/perforated appendicitis, shorter appendiceal length and specific appendiceal locations (retroileal, preileal, retrocecal, paracecal) were more likely to be associated with acute suppurative appendicitis, while complicated underlying diseases, absence of fever and specific appendiceal location (pelvic) were more likely to be associated with gangrenous/perforated appendicitis (odds ratios=0.095,<0.001, 0.001, 0.001, 0.004, 2.765, 3.978, 202.520, all P<0.05). Conclusion Younger age and shorter appendiceal length are more likely to indicate acute simple appendicitis, while complicated underlying diseases may lead to gangrenous/perforated appendicitis even in the absence of fever.