今天是:          
张艳梅 黄 琴 田袁静 谢 桢 陶 琦 杨 芳▲.三种评分系统联合高频超声在儿童急性阑尾炎诊断中的价值对比研究[J].中国现代医生,2021,59(30):123-127+封三
三种评分系统联合高频超声在儿童急性阑尾炎诊断中的价值对比研究
Comparison of diagnostic value of three scoring systems combined with high frequency ultrasound in children with acute appendicitis
  
DOI:
中文关键词:  改良Alvarado 评分  PAS 评分  AIR 评分  高频超声  急性阑尾炎  儿童
英文关键词:Modified Alvarado score  Pediatric appendicitis score  Appendicitis inflammatory response score  High frequency ultrasound  Acute appendicitis  Child
基金项目:
作者单位
张艳梅 黄 琴 田袁静 谢 桢 陶 琦 杨 芳▲ 安徽省儿童医院超声医学科安徽合肥 230051 
摘要点击次数: 420
全文下载次数: 1765
中文摘要:
      目的 比较改良Alvarado 评分、儿童阑尾炎评分(PAS)、阑尾炎炎症反应评分(AIR)系统联合高频超声(HFUS)在儿童急性阑尾炎(AA)诊断中的价值,为临床早期诊断AA 提供参考依据。方法 回顾性分析2019 年1 月至2020 年6 月因疑似AA 于安徽省儿童医院就诊并行腹腔镜探查术的559 例患儿临床资料,根据术后病理结果将其分为AA 组(n=538)和非AA 组(n=21)。分别使用改良Alvarado、PAS、AIR 评分系统对每例患儿评分,绘制受试者工作特征(ROC)曲线,计算各评分系统ROC 曲线下面积(AUC)及最佳诊断界值。最后分析比较各评分系统单独及联合HFUS 诊断儿童AA 的敏感度、特异度及准确度。结果 改良Alvarado、PAS、AIR 评分的AUC 分别为0.884、0.904、0.808,最佳诊断界值分别为7、6、6 分。单独诊断时,PAS 评分的敏感度、准确度(91.1%、90.5%)高于改良Alvarado 评分(83.5%、83.4%)及AIR 评分(82.3%、81.9%),差异有统计学意义(P<0.05),而特异度比较,差异无统计学意义(P>0.05)。联合诊断时,改良Alvarado、PAS、AIR 评分联合HFUS 的敏感度、准确度(98.3%、97.5%,98.5%、97.7%,98.1%、97.0%)均分别高于改良Alvarado 评分(83.5%、83.4%)、PAS 评分(91.1%、90.5%)、AIR 评分(82.3%、81.9%),差异有统计学意义(P<0.05),而特异度比较,差异均无统计学意义(P>0.05)。三种联合诊断方法之间的敏感度、特异度及准确度比较,差异均无统计学意义(P>0.05)。结论 改良Alvarado、PAS、AIR 评分系统对儿童AA 均有一定的诊断价值,而PAS 评分的诊断水平较高;各评分系统联合HFUS 的诊断效能优于单一评分系统,能够提高儿童AA 诊断的敏感度和准确度,值得临床推广使用。
英文摘要:
      Objective To compare diagnostic value of modified Alvarado score,pediatric appendicitis score (PAS) and appendicitis inflammatory response score (AIR) systems combined with high frequency ultrasound (HFUS) in children with acute appendicitis (AA),and provide reference for clinical early diagnosis of AA.Methods The clinical data of 559 children with suspected AA who were treated with laparoscopic exploration in Anhui Children's Hospital from January 2019 to June 2020 were retrospectively analyzed.According to the postoperative pathological result,they were divided into AA group(n=538) and non-AA group (n=21).The modified Alvarado,PAS and AIR scoring systems were used to score each child,the receiver operating characteristic (ROC) curve was drawn,the area under the ROC curve (AUC)and the best diagnostic cut-off value of each scoring system were calculated.Lastly,the sensitivity,specificity and accuracy of each scoring system alone and in combination with HFUS for diagnosis of pediatric AA were analyzed and compared.Results The AUC of modified Alvarado,PAS and AIR scores were 0.884,0.904 and 0.808.The best diagnostic cut-off values were 7,6 and 6 points,respectively.The sensitivity and accuracy of PAS score (91.1%,90.5%)were higher than those of modified Alvarado score (83.5%,83.4%) and AIR score (82.3%,81.9%),the difference was statistically significant (P<0.05).However,there was no statistically significant difference in specificity (P>0.05).The sensitivity and accuracy of modified Alvarado score(98.3%,97.5%),PAS score(98.5%,97.7%) and AIR score(98.1%,97.0%) combined with HFUS were higher than those of modified Alvarado score(83.5%,83.4%),PAS score(91.1%,90.5%)and AIR score(82.3%,81.9%),the difference was statistically significant (P<0.05),respectively.While there was no statistically significant difference in specificity(P>0.05).Moreover,there was no statistically significant difference in sensitivity,specificity and accuracy of three combined diagnostic methods (P>0.05).Conclusion The modified Alvarado,PAS and AIR scoring systems have certain diagnostic values for pediatric AA,while PAS has a higher diagnostic level.The diagnostic efficiency of each scoring system combined with HFUS is better than the single scoring system,which can improve sensitivity and accuracy of diagnosis of pediatric AA,which is worthy of clinical use.
查看全文  查看/发表评论  下载PDF阅读器
关闭
    • 关键词 :
    • 中国医生
    • 中国现代医生
    • 中国临床医生
    • 中国医师
    • 主任医师
    • 中国医学
    • 中华医学
    • 中国医院
    • 中国医药
    • 中国医疗
    • 现代医生
    • 现代医学
    • 现代医药
    • 现代医院
    • 现代药物
    • 现代护理
    • 现代临床
    • 医学杂志
    • 药学杂志
    • 医药杂志
    • 医生杂志
    • 医师杂志
    • 医疗杂志
    • 医药期刊
    • 医学期刊
    • 医药卫生期刊
    • 医药论文
    • 医学论文
    • 科研论文
    • 职称论文
    function PdfOpen(url){ var win="toolbar=no,location=no,directories=no,status=yes,menubar=yes,scrollbars=yes,resizable=yes"; window.open(url,"",win); } function openWin(url,w,h){ var win="toolbar=no,location=no,directories=no,status=no,menubar=no,scrollbars=yes,resizable=no,width=" + w + ",height=" + h; controlWindow=window.open(url,"",win); } &et=8C10CEA789A144B8281AEADD8B83F73873D04E9C44DBBDD26DA86480A77E560134F147E2FE8515D7EB390C52E33EF02A27CCD10E3420C4C9E3DAC0B0EB2DF74B0A48F381C71F7518879542413FADDDF2E45125A14D99180FA03473C8B30D88DFA1179AD8A714D20BF0B04B40784BD4615DE5D4F8FAB17CE19D15FE6B8176A853086BDC1491B70A2C&pcid=A9DB1C13C87CE289EA38239A9433C9DC&cid=BB33F1C95224820A&jid=8EDAEC11C165015425CEEA15366CB0A7&yid=9475FABC7A03F4AB&aid=&vid=&iid=340AC2BF8E7AB4FD&sid=AE09EACBCD1B2A13&eid=766F1B8F97C64E9A7D16AB76CA7FA747&fileno=2023189&flag=1&is_more=0">