摘要
目的探讨急性阑尾炎相关评分系统联合螺旋CT薄层重建检查对急性阑尾炎的诊断价值。方法选取2020年7月至2021年12月上海交通大学医学院苏州九龙医院收治的72例初步诊断为急性阑尾炎的患者作为研究对象,所有患者均采用手术治疗,并以病理结果作为金标准,术前进行螺旋CT薄层重建检查及阑尾炎炎症反应(appendicitis inflammatory response,AIR)评分和Alvarado评分对患者进行评估,分析AIR评分联合螺旋CT薄层重建及Alvarado评分联合螺旋CT薄层重建对急性阑尾炎患者的诊断价值。结果经手术病理检查,72例患者中68例确诊为急性阑尾炎;AIR评分联合螺旋CT薄层重建诊断阳性66例,阴性6例;Alvarado评分联合螺旋CT薄层重建诊断阳性60例,阴性12例。两种诊断方式对急性阑尾炎诊断的特异度及阳性预测值比较差异无统计学意义;AIR评分联合螺旋CT薄层重建对急性阑尾炎诊断的灵敏度、阴性预测值及准确度上均高于Alvarado评分联合螺旋CT薄层重建,差异有统计学意义(P<0.05)。结论AIR评分联合螺旋CT薄层重建对急性阑尾炎的诊断价值较高,可进一步提高急性阑尾炎的诊断率,且为无创检查,对急性阑尾炎患者的诊断和预后评估具有重要意义,值得临床推广应用。
Objective To investigate the diagnostic value of acute appendicitis-related scoring system combined with the spiral CT reconstruction in the diagnosis of acute appendicitis.Methods A total of 72 patients with initial diagnosis of acute appendicitis admitted to Suzhou Kowloon Hospital,Shanghai Jiao Tong University School of Medicine from July 2020 to December 2021 were selected as the study subjects,all patients had surgical pathology results as the gold standard,and preoperative spiral CT thin layer reconstruction and appendicitis inflammatory response(AIR)score and Alvarado score were evaluated to analyze the diagnostic value of AIR score combined with spiral CT thin layer reconstruction and Alvarado score combined with spiral CT thin layer reconstruction in patients with acute appendicitis.Results After surgical pathological examination,68 patients had confirmed acute appendicitis.The combination of spiral CT thin layer reconstruction with AIR score found 66 positive cases and 6 negative cases.Alvarado score combined with spiral CT thin layer reconstruction identified 60 positive cases and 12 negative cases.There were no significant differences in specificity and positive predictive value between the two diagnostic methods for acute appendicitis;the sensitivity and negative predictive value and accuracy of AIR score combined with spiral CT thin layer reconstruction were higher than that of Alvarado score combined with spiral CT thin layer reconstruction(P<0.05).Conclusion AIR score combined with spiral CT thin layer reconstruction has a high value for the diagnosis of acute appendicitis,and can further improve the diagnosis rate of acute appendicitis,with higher patient acceptance,and the diagnosis and prognosis evaluation of acute appendicitis patients,which is worthy of clinical application and promotion.
作者
毛郁琪
费建平
MAO Yuqi;FEI Jianping(Department of General Surgery,Suzhou Kowloon Hospital,Shanghai Jiao Tong University School of Medicine,Suzhou,Jiangsu,215000,China)
出处
《当代医学》
2024年第17期128-131,共4页
Contemporary Medicine
