Ratio of neutrophils to lymphocytes as predictor of outcome and course of inflammatoryprocess in patients with appendicular infiltration
The work presents the results of examination and treatment of 54 patients admitted to the surgical department for appendicular infiltration. The reason for applying for medical care in 43 (79.63%) patients was the increase in body temperature to subfebril digits, and in 47 (87.04%) - minor pain in the right iliac region. The duration of the disease (from the appearance of pain to hospitalization) was 5.6 ± 1.9 days. Clinical blood testing showed that most 31 (57.41%) of SOE patients and leukocyte levels exceeded the norm. When entering 5 (9.26%) patients had a subfebrilite during the week, with the last 2 days recording a rise in temperature to a 38,5Сº accompanied by ozone mainly in the afternoon. Palpatorically in the right iliac region the infiltration was determined to 10-12 cm in diameter, the level of SNL exceeded 6.9, and according to CT, in the area of the dome of the blind intestine and worm-like process, the cavity was determined to 46 mm in diameter with the level of liquid and gas, which I showed to the emergency operation. In 34 (60.71%) patients the body temperature did not rise above 37.4 C, in 15 (27.77%) - met the norm, the duration of the disease (from pain to hospitalization) ranged from 4 to 2 days, and palpatorically in the right iliac region the infiltration was determined, the SNL index did not exceed 4.8, and the CT data indicated the absence of abscessing. Against the background of the treatment on day 3-5 42 (77.78%) of patients noted an improvement, at the same time in 7 (12.96%) - the temperature reaction and the size of the infiltration remained the same, and the level of SNL tended to increase. Only after 48-72 hours clinically in these patients there was a deterioration of the general condition (increase of body temperature to 38.5 °, chills), and on the control sonography the cavity up to 25-30 mm with the level of liquid and gas was determined. These patients performed an autopsy and drainage of the purulent hearth. The growth of SNL against the background of the treatment in the absence of positive dynamics (reduction of pain, normalization of body temperature, reduction of infiltration sizes) is a predictor of abscession in patients with appendicular infiltration.