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1. 安徽省阜阳市妇女儿童医院超声诊断科
2. 皖北煤电总医院超声科
纸质出版日期:2020,
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[1]任强,徐伟,方群.高频超声联合血浆纤维蛋白原测定对小儿阑尾炎病理分型的价值[J].临床超声医学杂志,2020,22(10):785-788.
REN Qiang, XU Wei, FANG Qun. Value of high frequency ultrasound combined with plasma fibrinogen in the pathological typing of appendicitis in children[J]. Journal of Clinical Ultrasound in Medicine, 2020,22(10):785-788.
[1]任强,徐伟,方群.高频超声联合血浆纤维蛋白原测定对小儿阑尾炎病理分型的价值[J].临床超声医学杂志,2020,22(10):785-788. DOI: 10.16245/j.cnki.issn1008-6978.2020.10.020.
REN Qiang, XU Wei, FANG Qun. Value of high frequency ultrasound combined with plasma fibrinogen in the pathological typing of appendicitis in children[J]. Journal of Clinical Ultrasound in Medicine, 2020,22(10):785-788. DOI: 10.16245/j.cnki.issn1008-6978.2020.10.020.
目的探讨高频超声回盲部定位法联合血浆纤维蛋白原(FIB)测定在不同病理类型小儿阑尾炎诊断中的应用价值。方法选取我院收治的疑似阑尾炎患儿62例
术前均应用高频超声回盲部定位法联合FIB测定法进行检查
根据病理分型分为单纯性、化脓性、坏疽性阑尾炎组
同时选取健康小儿20例为健康对照组
比较各组FIB水平的差异。以手术及病理结果为标准
分析超声对不同病理类型阑尾炎诊断结果的一致性;绘制受试者工作特征(ROC)曲线评价超声联合FIB测定法对各类型小儿阑尾炎的诊断效能。结果 62例患儿经手术病理证实为急性阑尾炎60例
超声诊断总体符合率为100%。超声对各类型阑尾炎诊断结果与病理结果的一致性一般(Kappa=0.746
P=0.000)。单纯性、化脓性、坏疽性阑尾炎组FIB水平依次升高
且均明显高于健康对照组
差异均有统计学意义(均P<0.05)。FIB测定法诊断单纯性、化脓性、坏疽性阑尾炎的ROC曲线下面积分别为0.685、0.743、0.785
截断值分别为2.37 g/L、3.68 g/L、4.72 g/L
敏感性分别为70.87%、72.59%、83.09%。超声回盲部定位法联合FIB测定法诊断单纯性、化脓性、坏疽性阑尾炎的ROC曲线下面积分别为0.853、0.872、0.895
敏感性分别为87.50%、90.91%、95.45%
特异性分别为75.00%、61.22%、73.68%。结论高频超声回盲部定位法诊断小儿阑尾炎的总体符合率较高
但对于不典型的阑尾炎其诊断敏感性较低
联合FIB测定法可以进一步提高对各类型小儿阑尾炎的诊断敏感性
具有重要的临床应用价值。
Objective To explore the application value of high frequency ultrasound ileocecal localization combined with plasma fibrinogen(FIB) in the diagnosis of appendicitis in children with different pathological types.Methods Sixty-two children with suspected appendicitis in our hospital were enrolled
they were examined by high-frequency ultrasound ileocecal localization combined with FIB
the children were divided into simple appendictitis
suppurative appendicitis and gangrene appendicitis according to pathological type.At the same time
20 healthy children were selected as healthy group.The difference of FIB level among groups were compared.Taken surgical and pathological results as standard
the consistency of ultrasonography in the diagnosis of appendicitis in children with different pathological types were analyzed.The accuracy
sensitivity and specificity of ultrasound combined with FIB level in the diagnosis of appendicitis in children were calculated by ROC curve.Results Sixty of 62 cases were confirmed as acute appendicitis by surgerg and pathology
the overall coincidence rate of ultrasound was 100%. However
compared with the pathological results
the diagnostic consistency of ultrasound for each type of appendicitis was general(Kappa=0.746
P=0.000). The FIB level of children with simple
suppurative
gangrene appendicitis was gradually aggravated. The FIB level of children with appendicitis in each group was significantly higher than that of the healthy group(all P<0.05).The area under ROC curve of FIB in the diagnosis of simple appendicitis
suppurative appendicitis and gangrene appendicitis were 0.685
0.743 and 0.785
respectively. The cut-off values were 2.37 g/L
3.68 g/L and 4.72 g/L
respectively. The sensitivity were 70.87%
72.59%
83.09%
respectively. The area under the curve of FIB combined with ultrasound ileocecal localization in the diagnosis of simple appendicitis
suppurative appendicitis and gangrene appendicitis were 0.853
0.872 and 0.895
respectively.The sensitivity were 87.50%
90.91% and 95.45%
and the specificity were 75.00%
61.22% and 73.68%
respectively.Conclusion The application of ultrasound technology is accurate in the diagnosis of appendicitis in children
but it lacks higher sensitivity for less typical appendicitis. High frequency ultrasound ileocecal localization combined with FIB can further improve various types of appendicitis in children
which has important clinical application value.
超声检查纤维蛋白原阑尾炎儿童
UltrasonographyFibrinogenAppendicitisChildren
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