小儿气管支气管阴性异物行X射线结合CT重建诊断的临床价值分析

Analysis of the Clinical Value of X-Ray Combined with CT Reconstruction in the Diagnosis of Negative Tracheobronchial Foreign Body in Children

目的:研究小儿气管支气管阴性异物行X射线结合CT重建诊断的临床价值。方法:选择2018年9月~2020年9月于本院收治的疑似气管支气管阴性异物患儿共44例,均采用CT重建与X射线诊断方式,并将支气管镜检查结果作为金标准,研究对比患者的诊断结果、阴性似然比、阳性似然比、特异性和敏感性。结果:气管支气管阴性异物确诊方面,气管支气管阴性异物37例,气管无异物7例。相较于X射线、CT重建单一诊断,两者联合诊断的正确率更高(P<0.05)。特异度、敏感度、阴性似然比、阳性似然比方面,X射线检查分别为57.14%、70.27%、26.67%、89.66%;CT重建诊断分别为71.43%、78.38%、38.46%、93.55%;两者联合检测分别为100.00%、97.30%、87.50%、100.00%,相较于X射线、CT重建单一诊断,两者联合诊断的特异度、敏感度、阴性似然比、阳性似然比更高(P<0.05)。结论:CT重建结合X射线诊断对于提高小儿支气管、气管阴性异物特异性和敏感性,早期予以处理等有十分重要的意义。

Objective:To investigate the clinical value of X-ray combined with CT reconstruction in the diagnosis of negative tracheobronchial foreign bodies in children.Methods:In our hospital from September 2018 to September 2020,admitted during the period of this negative foreign body,a total of 44 cases of children with suspected tracheal bronchus,adopt CT reconstruction and X-ray diagnosis way,bronchoscopy and the result was as gold standard,the study compared the patient’s diagnosis and negative likelihood ratio,positive likelihood ratio,specificity and sensitivity.Results:In the diagnosis of tracheobronchial negative foreign bodies,37 cases had tracheobronchial negative foreign bodies and 7 cases had no foreign bodies in trachea.Compared with the single diagnosis of X-ray and CT reconstruction,the accuracy of combined diagnosis was higher(P<0.05).The specificity,sensitivity,negative likelihood ratio and positive likelihood ratio were 57.14%,70.27%,26.67%and 89.66%respectively;CT reconstruction diagnosis was 71.43%,78.38%,38.46%and 93.55%respectively;The combined detection of the two were 100.00%,97.30%,87.50%and 100.00%respectively.Compared with the single diagnosis of X-ray and CT reconstruction,the specificity,sensitivity,negative likelihood ratio and positive likelihood ratio of the combined diagnosis were higher(P<0.05).Conclusion:CT reconstruction combined with X-ray diagnosis is of great significance in improving the specificity and sensitivity of negative foreign body in bronchus and trachea in children and early treatment.