超声联合后蹬腿运动试验诊断儿童阑尾疾病的价值

Value of ultrasonography combined with post-pedaling exercise test in diagnosis of appendix diseases of children

目的探讨超声联合后蹬腿运动试验诊断儿童阑尾疾病的价值。方法回顾性分析疑诊急性阑尾炎182例患儿的超声图像、后蹬腿运动试验和病理诊断资料。结果 182例患儿中,病理确诊阑尾疾病170例(93.4%),超声诊断为阑尾疾病158例(86.8%);其中,超声表现为黏膜层增厚22例,黏膜层及黏膜下层增厚92例,黏膜层、黏膜下层及肌层增厚44例。联合后蹬腿运动试验诊断阑尾炎167例(91.8%)。所检超声阳性患儿中后蹬腿运动试验均表现为阳性;9例超声阴性患儿中4例因过度肥胖漏诊,5例因过度肥胖并后位阑尾漏诊。结论超声可作为儿童阑尾疾病的首选检查方法,联合后蹬腿运动试验可提高儿童阑尾疾病的诊断率。

Objective To explore the value of ultrasonography combined with post-pedaling exercise test in the diagnosis of appendix diseases of children.Methods Data of ultrasonography,postpedaling exercise test and pathology were retrospectively analyzed in 182 children suspected to have acute appendicitis.Results Of 182 cases,the appendix diseases were confirmed pathologically in 170 cases（93.4%）and were diagnosed by ultrasonography in 158 cases（86.8%）,which manifested by thickening of mucous membrane in 22 cases,thickening of mucous membrane and submucosa in 92 cases,thickening of mucous membrane,submucosa and muscular layer in 44 cases.Of 182 cases,the appendix diseases were diagnosed by ultrasonography combined with post-pedaling exercise test in 167 chirden（92.3%）.The post-pedaling exercise test was positive in all the cases who were with positive findings on ultrasonography.Of 9 cases with negative performance on ultrasonography,4 cases were due to obesity and 5 cases were obesity plus retrocecal appendicitis.Conclusion Ultrasonography can be used as the first examination method for the children with appendix diseases.The diagnosis rate of children appendiceal diseases can be improved by combined use of ultrasonography and post-pedaling exercise test.