腹部浅表超声在急性阑尾炎诊断中的应用研究

Application of abdominal superficial ultrasound in diagnosis of acute appendicitis

目的:研究腹部浅表超声诊断急性阑尾炎的价值。方法:选取2022年1月至2023年1月期间本院收治的均行手术治疗的60例高度疑似急性阑尾炎患者作为研究对象。于术前接受腹部浅表超声检查。以手术病理结果作为金标准对患者进行急性阑尾炎及分型诊断。分析对比腹部浅表超声对急性阑尾炎的诊断结果;计算腹部浅表超声诊断急性阑尾炎的价值以及鉴别不同分型急性阑尾炎的价值。结果:手术病理结果显示,60例患者中有56例明确为急性阑尾炎,占比为93.33%;56例急性阑尾炎患者中单纯性18例、化脓性14例、坏疽性17例、阑尾周围脓肿7例,各占比32.14%、25.00%、30.36%、12.50%。腹部浅表超声诊断急性阑尾炎的特异度为75.00%(3/4)、灵敏度为96.43%(54/56)、准确度为95.00%(57/60)、阳性预测值为98.18%(54/55)、阴性预测值为60.00%(3/5),与金标准的一致性一般(Kappa=0.880,P<0.001)。以病理结果作为急性阑尾炎分型诊断的金标准,腹部浅表超声鉴别诊断急性阑尾炎分型的准确率为94.64%(53/56),与金标准的一致性好(Kappa=0.927,P<0.001)。结论:腹部浅表超声对急性阑尾炎的诊断价值一般,但用于诊断不同分型的急性阑尾炎的具有较高的诊断价值。

Objective:To study the value of superficial abdominal ultrasonography in the diagnosis of acute appendicitis.Methods:60 patients with highly suspected acute appendicitis who underwent surgical treatment in our hospital from January 2022 to January 2023 were selected as the study objects.Superficial abdominal ultrasonography was performed before operation.The surgical and pathological results were used as the gold standard for the diagnosis of acute appendicitis.The diagnosis results of acute appendicitis by superficial abdominal ultrasound were analyzed and compared.The value of superficial abdominal ultrasonography in diagnosing acute appendicitis and differentiating different types of acute appendicitis were analyzed.Results:The pathological results showed that 56 of the 60 patients were acute appendicitis,accounting for 93.33%.Among 56 cases of acute appendicitis,18 cases were simple,14 cases were suppurative,17 cases were gangrenous and 7 cases were peri appendiceal abscess.The specificity,sensitivity,accuracy,positive predictive value,positive predictive value and negative predictive value were 75.00%(3/4),96.43%(54/56),95.00%(57/60),98.18%(54/55)and 60.00%(3/5)in the diagnosis of acute appendicitis.The agreement with gold standard was general(Kappa=0.640,P<0.001).Pathological results were used as the gold standard for the classification of acute appendicitis.The accuracy of differential diagnosis of acute appendicitis by superficial abdominal ultrasound was 94.64%(53/56),which was in good agreement with the gold standard(Kappa=0.927,P<0.001).Conclusion:The value of superficial abdominal ultrasound in the diagnosis of acute appendicitis is general,but it has a higher value in the diagnosis of different types of acute appendicitis.