PAS评分、Alvarado评分、高频彩色多普勒超声检查联合模式对小儿急性阑尾炎早期快速诊断的可行性与有效性  

Feasibility and effectiveness of the combined mode of PAS score,Alvarado score and high-frequency color Doppler for early and rapid diagnosis of acute appendicitis in children

作　　者：阿尔孜古丽·托合提 杜典国 凯沙尔·吾司曼 玉苏甫·阿克木 AERZIGULI Tuoheti;DU Dianguo;KAISHAER Wusiman;YUSUFU Akemu(Department of Ultrasound,Children's Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830054,China)

机构地区：[1]新疆维吾尔自治区儿童医院超声科,新疆乌鲁木齐830054

出　　处：《医学影像学杂志》2024年第4期73-76,80,共5页Journal of Medical Imaging

基　　金：新疆维吾尔自治区科技计划项目(编号:2019D03029)。

摘　　要：目的 探讨小儿阑尾炎评分(PAS)评分、Alvarado联合高频彩色多普勒超声对小儿急性阑尾炎(AP)的早期快速诊断价值。方法 选取我院诊治的170例疑似AP患儿,分为AP组(121例)和非AP组(49例),AP组分为急性单纯性阑尾炎组(41例)和急性化脓坏疽性阑尾炎组(80例)。用受试者工作特征曲线探讨Alvarado评分、PAS评分及联合检测对小儿AP的诊断价值。探讨高频彩色多普勒超声检查单独及联合Alvarado评分、PAS评分模式诊断小儿AP及急性化脓坏疽性阑尾炎的诊断价值。结果 AP组恶心呕吐、转移性右下腹痛、右下腹压痛反跳痛、腹肌紧张的发生率,白细胞计数和中性粒细胞百分比显著高于非AP组,差异有统计学意义(P<0.05)。相比于非AP组,AP组PAS评分、Alvarado评分明显较高(t=12.929、14.256,P<0.001),高频彩色多普勒超声检查阳性率显著较高,差异有统计学意义(χ^(2)=27.154,P<0.001)。与单独检测相比,PAS评分、Alvarado评分联合检测对AP具有较高的诊断价值(Z=2.810、7.229,P<0.05)。高频彩色多普勒超声检查联合PAS评分、Alvarado评分诊断AP及急性化脓坏疽性阑尾炎的敏感度及阴性预测值明显高于单独高频彩色多普勒超声检查及PAS评分、Alvarado评分联合检测,差异有统计学意义(P<0.05)。结论 PAS评分、Alvarado评分、高频彩色多普勒超声检查联合模式对小儿AP有较高的早期快速诊断价值,具有良好的可行性与有效性。Objective To study the feasibility and effectiveness of PAS score,Alvarado score combined with high frequency color Doppler ultrasound in the early and rapid diagnosis of acute appendicitis(AP)in children.Methods 170 children with suspected AP who were treated by surgery in our hospital were analyzed as the research objects.The subjects were divided into AP group(121 cases)and non-AP group(49 cases),and AP group was divided into acute simple appendicitis group(41 cases)and acute suppurative gangrene appendicitis group(80 cases).The receiver operating curve was used to explore the diagnostic value of Alvarado score,PAS score and combined detection in children with AP.The diagnostic value of high-frequency color Doppler ultrasound alone or in combination with Alvarado score and PAS score in the diagnosis of AP and acute suppurative gangrenous appendicitis in children were investigated.Results The incidences of nausea and vomiting,metastatic right lower quadrant pain,right lower quadrant tenderness and rebound tenderness,and abdominal muscle tension in the AP group were significantly higher than those in the non AP group(P<0.05).Compared with the non-AP group,the AP group had significantly higher PAS scores and Alvarado scores(t=12.929,14.256,P<0.001),and the positive rate of high-frequency color Doppler ultrasound was significantly higher(χ^(2)=27.154,P<0.001).Compared with single detection,combined detection of PAS score and Alvarado score had higher diagnostic value for acute appendicitis(Z=2.810,7.229,P<0.05).The sensitivity and negative predictive value of high-frequency color Doppler ultrasound combined with PAS score and Alvarado score in the diagnosis of AP and acute suppurative gangrenous appendicitis were significantly higher than those of high-frequency color Doppler ultrasound and the combined detection of PAS score,or Alvarado score alone(P<0.05).Conclusion The combined mode of PAS score,Alvarado score and high-frequency color Doppler ultrasound has good early and rapid diagnostic value for children wi

关 键 词：急性阑尾炎 PAS评分 Alvarado评分 高频彩色多普勒超声 快速诊断 

分 类 号：R658[医药卫生—外科学] R445.1[医药卫生—临床医学]