超声对儿童急性阑尾炎的诊断价值

Value of ultrasound in the diagnosis of acute appendicitis in children

目的探讨超声对阑尾外径为0.6~0.7 cm儿童急性阑尾炎的临床诊断价值。方法选取我院疑诊为急性阑尾炎并行超声检查的患儿202例(超声测得阑尾外径均为0.6~0.7 cm),根据最终诊断结果分为阑尾炎组102例和非阑尾炎组100例,比较两组超声征象的差异。绘制受试者工作特征(ROC)曲线分析不同超声征象对儿童急性阑尾炎的诊断效能。结果两组超声征象为阑尾周围系膜网膜增厚、阑尾腔内粪石及阑尾周围积液的患儿占比比较差异均有统计学意义(均P<0.05)。ROC曲线分析显示以阑尾周围系膜网膜增厚诊断儿童急性阑尾炎的曲线下面积为0.906(95%可信区间:0.855~0.957),高于阑尾腔内粪石和阑尾周围积液的曲线下面积[0.607(95%可信区间:0.536~0.675)、0.667(95%可信区间:0.597~0.731),差异均有统计学意义(均P<0.001)]。结论超声对阑尾外径为0.6~0.7 cm儿童急性阑尾炎有较好的临床诊断价值,其中超声征象阑尾周围系膜网膜增厚价值更高。

Objective To explore the clinical value of ultrasound in the diagnosis of acute appendicitis in children with external diameter of the appendix was 0.6~0.7 cm.Methods A total of 202 children suspected of acute appendicitis(external diameter of the appendix measured by ultrasound was 0.6~0.7 cm)and received ultrasonography in our hospital were collected,they were divided into the appendicitis group(n=102)and the non-appendicitis group(n=100)according to the final clinical diagnosis results,and the differences in ultrasonic signs between the two groups were compared.Receiver operating characteristic(ROC)curve was drawn to analyze the efficacy of different ultrasonic signs in the diagnosis of acute appendicitis in children.Results There were statistically significant differences in the proportion of children with ultrasonic signs of mesangial omentum thickening around the appendix,fecalith in the appendix cavity and periappendicular effusion between the two groups(all P<0.05).ROC curve analysis showed that the area under the curve of mesomentum thickening around the appendix in the diagnosis of acute appendicitis in children was 0.906(95%confidence interval:0.855~0.957),which was higher than that of appendiceal fecal calculus and periappendiceal effusion[0.607(95%confidence interval:0.855~0.957),0.667(95%confidence interval:0.597~0.731)],the differences were statistically significant(both P<0.001).Conclusion Ultrasound has good clinical value in the diagnosis of acute appendicitis in children with external diameter of the appendix is 0.6~0.7 cm,and the mesomentum thickening around the appendix has higher value.