高频超声联合血浆纤维蛋白原测定对小儿阑尾炎病理分型的价值  

Value of high frequency ultrasound combined with plasma fibrinogen in the pathological typing of appendicitis in children

作　　者：任强 徐伟 方群 REN Qiang;XU Wei;FANG Qun(Department of Ultrasound Diagnosis,Fuyang Women and Children’s Hospital,Anhui 236000,China)

机构地区：[1]安徽省阜阳市妇女儿童医院超声诊断科,236000 [2]皖北煤电总医院超声科

出　　处：《临床超声医学杂志》2020年第10期785-788,共4页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨高频超声回盲部定位法联合血浆纤维蛋白原(FIB)测定在不同病理类型小儿阑尾炎诊断中的应用价值。方法选取我院收治的疑似阑尾炎患儿62例,术前均应用高频超声回盲部定位法联合FIB测定法进行检查,根据病理分型分为单纯性、化脓性、坏疽性阑尾炎组,同时选取健康小儿20例为健康对照组,比较各组FIB水平的差异。以手术及病理结果为标准,分析超声对不同病理类型阑尾炎诊断结果的一致性;绘制受试者工作特征(ROC)曲线评价超声联合FIB测定法对各类型小儿阑尾炎的诊断效能。结果62例患儿经手术病理证实为急性阑尾炎60例,超声诊断总体符合率为100%。超声对各类型阑尾炎诊断结果与病理结果的一致性一般(Kappa=0.746,P=0.000)。单纯性、化脓性、坏疽性阑尾炎组FIB水平依次升高,且均明显高于健康对照组,差异均有统计学意义(均P<0.05)。FIB测定法诊断单纯性、化脓性、坏疽性阑尾炎的ROC曲线下面积分别为0.685、0.743、0.785,截断值分别为2.37 g/L、3.68 g/L、4.72 g/L,敏感性分别为70.87%、72.59%、83.09%。超声回盲部定位法联合FIB测定法诊断单纯性、化脓性、坏疽性阑尾炎的ROC曲线下面积分别为0.853、0.872、0.895,敏感性分别为87.50%、90.91%、95.45%,特异性分别为75.00%、61.22%、73.68%。结论高频超声回盲部定位法诊断小儿阑尾炎的总体符合率较高,但对于不典型的阑尾炎其诊断敏感性较低,联合FIB测定法可以进一步提高对各类型小儿阑尾炎的诊断敏感性,具有重要的临床应用价值。Objective To explore the application value of high frequency ultrasound ileocecal localization combined with plasma fibrinogen(FIB)in the diagnosis of appendicitis in children with different pathological types.Methods Sixty-two children with suspected appendicitis in our hospital were enrolled,they were examined by high-frequency ultrasound ileocecal localization combined with FIB,the children were divided into simple appendictitis,suppurative appendicitis and gangrene appendicitis according to pathological type.At the same time,20 healthy children were selected as healthy group.The difference of FIB level among groups were compared.Taken surgical and pathological results as standard,the consistency of ultrasonography in the diagnosis of appendicitis in children with different pathological types were analyzed.The accuracy,sensitivity and specificity of ultrasound combined with FIB level in the diagnosis of appendicitis in children were calculated by ROC curve.Results Sixty of 62 cases were confirmed as acute appendicitis by surgerg and pathology,the overall coincidence rate of ultrasound was 100%.However,compared with the pathological results,the diagnostic consistency of ultrasound for each type of appendicitis was general(Kappa=0.746,P=0.000).The FIB level of children with simple,suppurative,gangrene appendicitis was gradually aggravated.The FIB level of children with appendicitis in each group was significantly higher than that of the healthy group(all P<0.05).The area under ROC curve of FIB in the diagnosis of simple appendicitis,suppurative appendicitis and gangrene appendicitis were 0.685,0.743 and 0.785,respectively.The cut-off values were 2.37 g/L,3.68 g/L and 4.72 g/L,respectively.The sensitivity were 70.87%,72.59%,83.09%,respectively.The area under the curve of FIB combined with ultrasound ileocecal localization in the diagnosis of simple appendicitis,suppurative appendicitis and gangrene appendicitis were 0.853,0.872 and 0.895,respectively.The sensitivity were 87.50%,90.91%and 95.45%,and the specificit

关 键 词：超声检查 纤维蛋白原 阑尾炎 儿童 

分 类 号：R445.1[医药卫生—影像医学与核医学] R573.9[医药卫生—诊断学]