改良Alvarado评分对急性阑尾炎的诊断价值分析

Application of modified Alvarado scoring system in the diagnosis and treatment of acute appendicitis

目的 探讨改良Alvarado评分对急性阑尾炎诊断和治疗价值.方法 回顾我院自1985年1月至2009年12月间收治的行阑尾切除术并有完整临床资料的患者1637例,计算改良Alvarado评分,比较评分≥7分患者（833例）及＜7分患者（804例）的阴性切除率；计算评分的阳性预测率；并对评分结果和病理诊断进行相关分析.结果 评分≥7分患者阴性切除率明显低于评分〈7分患者,差异有统计学意义；评分阳性预测率为93.8%；评分分值和病理分型成正相关（r=0.637,P〈0.01）.结论 应用改良Alvarado评分能提高急性阑尾炎的诊断率,显著降低阴性阑尾切除率.

Objective To study the application of Alvarado scoring system in the diagnosis and treatment of acute appendicitis. Methods The dada of the Alvarado scores of 1637 patients with acute appendicitis who were admitted to our hospital and underwent appendectomy between January 1985 and December 2009 were retrospectively analyzed. The patients were divided into two groups in terms of the score：≥7 group（ n = 833 ）and 〈 7 group（ n = 804）. The negative resection rate was compared between the two groups. Validity of scoring system was assessed by calculating the positive predictive value. The correlation of the Alvarado scores and pathological type was analyzed. Results There was significant difference in the negative resection rate between two groups. The positive predictive value was 93.8%. The correlation between the Alvarado scores and pathological type was positive（ r =0.637 ,P 〈 0.01 ）. Conclusion The application of Alvarado scoring system improves diagnostic accuracy of acute appendicitis and reduces the negative resection rate.