高分辨率CT检查联合CRP对儿童复杂性阑尾炎的临床诊断价值研究

High Resolution CT Combined with CRP in the Diagnosis of Complex Appendicitis in Children

目的:探讨高分辨率CT检查联合CRP对儿童复杂性阑尾炎的临床诊断价值。方法:回顾性分析2019年9月至2022年12月就诊于莆田学院附属医院小儿外科诊断为儿童急性阑尾炎296例且行腹腔镜阑尾切除术的儿童患者的临床病理,按照病理结果将病例分为单纯性阑尾炎(simple appendicitis,SA)组及复杂性阑尾炎(complex appendicitis,CA)两组。比较两组患者在年龄、性别、发热、呕吐、腹痛、血常规检查及CT影像征象间的差异,当P<0.05时差异具有统计学意义。结果:本研究共纳入患儿296人,其中SA组261人,CA组35人。分析结果显示,两组在是否发热、CRP、阑尾外径增粗、是否合并周围脂肪间隙模糊渗出、是否阑尾周围脓肿形成、是否合并腔内外气体、是否伴有盆腔积液差异具有统计学意义,P值均<0.05;而两组在白细胞计数、血小板、NLR、PLR等方面均无统计学差异P值均>0.05。结论:CT影像学征象联合CRP对儿童复杂性阑尾炎的临床诊断具有较好的预测价值,避免延误治疗,为临床治疗方案的选择提供依据。

Objective:To investigate the clinical diagnostic value of high resolution CT combined with CRP in children with complex appendicitis.Methods:Retrospective analysis was made on the clinicopathology of 296 pediatric patients diagnosed with acute appendicitis who underwent laparoscopic appendectomy in the pediatric surgery Department of the Affiliated Hospital of Putian University from September 2019 to December 2022.According to the pathological results,the cases were divided into simpleappendicitis(simpleappendicitis),SA group and complexappendicitis(CA)group.The differences in age,gender,fever,vomiting,abdominal pain,routine blood examination and CT image signs between the two groups were compared,and the dfferences were statistically significant when P<0.05.Results:A total of 296 children were included in this study,including 261 in the SA group and 35 in the CA group.The analysis results showed that there were statistically significant differences between the two groups in fever,CRP,appendectomy diameter thickening,appendectomy fat space fuzzy exudation,appendectomy abscess formation,appendectomy gas in and out of the cavity,and pelvic effusion,with all P values<0.05.There were no significant differences in white blood cell count,platelet,NLR and PLR between the two groups,all P>0.05.Conclusion:CT imaging signs and CRP have good predictive value for complex appendicitis in children,which can avoid delayed treatment and provide evidence for the selection of clinical treatment.