CT影像联合改良Alvarado评分诊断不同病理类型下成人急性阑尾炎的临床研究

Clinical study of CT imaging combined with modified Alvarado score in the diagnosis of acute appendicitis in adults with different pathological types

目的探究与分析CT影像联合改良Alvarado评分诊断不同病理类型下成人急性阑尾炎的临床效果。方法选取2016年5月—2018年5月我院收治的89例成人急性阑尾炎作为研究对象,按照病理证实结果分为单纯组(n=32例)、化脓组(n=30例)及坏疽组(n=27例),统计三组不同病理类型下成人急性阑尾炎的临床资料,并采用CT影像与改良Alvarado评分对其诊断,将CT影像检查结果与改良Alvarado评分结果进行比较,对比准确率、敏感度、特异度、阳性预测值及阴性预测值。结果化脓组与坏疽组的心率、呼吸频率及体温分别与单纯组相比较高,坏疽组与化脓组相比心率、呼吸频率及体温较高,差异具有统计学意义(P<0.05)。单纯组的CT诊断准确率、敏感度、特异度与改良Alvarado评分相比无明显差异(P>0.05)。化脓组及坏疽组CT诊断准确率、敏感度、特异度与改良Alvarado评分相比较高,差异具有统计学意义(P<0.05)。结论 CT影像联合改良Alvarado评分诊断不同病理类型下成人急性阑尾炎具有一定的预测价值,二者联合应用有助于提高诊断的准确率,为后续的治疗提供有效的临床依据。

Objective To explore and analyze the clinical effect of combined CT image and modified Alvarado score in the diagnosis of acute appendicitis in adults under different pathological types.Methods From May 2016 to May 2018,89 cases of adult patients suffered with acute appendicitis and got treatment in our hospital were chose as the research objects.According to the pathology results the patients were divided into simple group( n = 32),pyogenic group( n = 30) and gangrene group( n = 2),the clinical data of the patients in the three groups were counted.CT image and modified Alvarado score was separately used for its diagnosis,and compared the results of CT imaging and modified Alvarado score,compare the degree of accuracy,sensitivity,specific,positive predictive value and negative predictive value.Results The heart rate,breathing rate and body temperature of the pyogenic group and the gangrene group were higher than those of the pure group.The heart rate,breathing rate and body temperature of the gangrene group were higher than those of the pyogenic group,with statistically significant differences( P<0.05).The accuracy,sensitivity and specificity of CT diagnostic were not significantly different from the modified Alvarado score in simple group( P >0.05).The CT diagnostic accuracy,sensitivity and specificity of the pyogenic group and the gangrene group were higher than those of the modified Alvarado score( P<0.05).Conclusions The combination of CT image and modified Alvarado score has certain predictive value for the diagnosis of acute appendicitis in adults under different pathological types,and the combined application of the two methods is helpful to improve the accuracy of diagnosis and provide an effective clinical basis for subsequent treatment.