河北医科大学学报

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2种评分系统联合高频彩色超声对小儿急性阑尾炎临床诊断的价值

  

  1. 1.四川省南充市第四人民医院功能检查科，四川 南充 637000；2.四川省南充市中心医院超声科，四川 南充 637000
  • 出版日期:2017-10-25 发布日期:2017-10-18
  • 作者简介:庞琳（1965-），女，四川成都人，四川省南充市第四人民医院副主任医师，从事医学超声诊断研究。

Clinical value of two scoring systems combined with high frequency color Doppler ultrasound in the diagnosis of acute appendicitis in children#br#

  1. 1.Department of Ultrasound, the Forth People′s Hospital in Nanchong City, Sichuan Province,
    6370002, China; 2.Department of Ultrasound, the Central Hospital in Nanchong City,
    Sichuan Province, 637000, China
  • Online:2017-10-25 Published:2017-10-18

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摘要： ［摘要］〓
〖HTH〗目的〖HTSS〗〖KG*2〗探讨儿科阑尾炎评分（pediatric appendicitis score，PAS）、Alvarado评分系统联合高频彩色超声对小儿急性阑尾炎临床诊断的价值。
〖HTH〗方法〖HTSS〗〖KG*2〗250例因腹痛就诊的患儿入院后接受高频彩色超声检查和PAS、Alvarado评分打分，并于阑尾切除术后进行病理检查诊断。采用ROC曲线分析2种评分系统联合高频彩色超声诊断小儿急性阑尾炎的灵敏度、特异度。
〖HTH〗结果〖HTSS〗〖KG*2〗250例患儿经组织病理学检查确诊急性化脓性阑尾炎234例（93.6%），急性单纯性阑尾炎16例(6.4%)；Alvarado评分和PAS低危、中危、高危患儿构成比分布差异无统计学意义（P＞0.05）。Alvarado评分和PAS诊断急性阑尾炎最佳临界值为6分，Alvarado、PAS诊断急性阑尾炎的灵敏度和特异度分别为73.5%和81.3%、 77.4%和87.5%。2种评分系统联合高频彩色超声诊断急性阑尾炎的灵敏度（99.6%）显著高于Alvarado评分联合高频彩色超声（82.1%）和PAS联合高频彩色超声（85.0%），差异有统计学意义（P＜0.05）。
〖HTH〗结论〖HTSS〗〖KG*2〗PAS、Alvarado评分系统对小儿急性阑尾炎具有诊断价值，但2种评分联合高频彩色超声诊断效能优于单一评分系统或单一评分系统联合高频彩色超声，能够提高小儿急性阑尾炎诊断的灵敏度和特异度，值得临床推广使用。

关键词: 阑尾炎, 评分系统, 超声检查, 儿童

Abstract: ［Abstract］ Objective〖HTSS〗〓To investigate the value of pediatric appendicitis score(PAS) and alvarado score system combined with high frequency color doppler ultrasonography for clinical diagnosis of children's acute appendicitis.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓Two hundred and fifty  cases of children with abdominal pain were accepted the examination of high frequency color ultrasonography and were tested with pediatric appendicitis score and alvarado score system after admission, and then were checked with pathological diagnosis after appendectomy. The sensitivity and specificity of 2 scoring systems combined with high frequency color doppler ultrasound for diagnosis of acute appendicitis in children were analyzed by ROC curve.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓 Histopathological examination revealed 234 cases of acute purulent appendicitis(234/250, 93.6%) and 16 patients with acute simple appendicitis(16/250, 6.4%). The incidence of acute appendicitis by Alvarado and PAS scores was statistically significant among the lowrisk group, the middle risk group and the highrisk group(P>0.05). The critical diagnostic threshold for acute appendicitis was 6 points for the Alvarado and PAS scores. The sensitivity and specificity of Alvarado and PAS scoring in the diagnosis of acute appendicitis were 73.5% and 81.3%, 77.4% and 87.5% respectively. The sensitivity of combined with high frequency ultrasonography of acute appendicitis two scoring system(99.6%) was significantly higher than that of Alvarado score combined with high frequency ultrasound(82.1%)(χ2=6.327, P=0.020), PAS score combined with high frequency ultrasound(85.0%)(χ2=34.791, P=0.000). 
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The alvarado and PAS scoring system are valuable for the diagnosis of acute appendicitis in children, but the efficiency of 2 score combined with high frequency ultrasound diagnostic is better than a single scoring system or single scoring system combined with high frequency color doppler ultrasonography, which can improve the sensitivity and specificity of the diagnosis of children's acute appendicitis, and is worthy of clinical use.

Key words: appendicitis, scoring system, ultrasonography, children

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