使用计算机断层扫描诊断儿童急性阑尾炎不会影响阴性阑尾切除术或穿孔的总体发生率。

The use of computed tomography for the diagnosis of acute appendicitis in children does not influence the overall rate of negative appendectomy or perforation.

作者信息

Weyant M J, Eachempati S R, Maluccio M A, Spigland N, Hydo L J, Barie P S

机构信息

Department of Surgery, New York-Presbyterian Hospital and Weill Medical College of Cornell University, New York, NY 10021, USA.

出版信息

Surg Infect (Larchmt). 2001 Spring;2(1):19-23. doi: 10.1089/109629601750185325.

DOI:10.1089/109629601750185325

PMID:12594877

Abstract

BACKGROUND

Computed tomography (CT) has been used more frequently to diagnose acute appendicitis in children. The purpose of this study was to determine whether the use of CT has any influence on negative appendectomy or perforation rates.

METHODS

Review of a prospective database of children having appendectomy for suspected acute appendicitis. Negative appendectomy and perforation rates were determined by correlation with final pathology reports.

RESULTS

Eighty-five consecutive patients underwent appendectomy for the suspicion of acute appendicitis. The overall negative appendectomy rate was 17.6%, being 19.4% in females and 16.6% in males (p = 0.75). The overall accuracy, sensitivity and positive predictive value of CT were 75%, 91%, and 81%, respectively. Patients that had CT did not have a significantly lower rate of negative appendectomy (17.9% vs. 19.3%, p > 0.99) or perforation (26% vs. 17%; p = 0.53).

CONCLUSIONS

The use of CT for the diagnosis of appendicitis in children does not change the negative appendectomy rate. Results of studies performed in adults may not be extrapolated to the evaluation of children with suspected acute appendicitis.

摘要

背景

计算机断层扫描（CT）已越来越频繁地用于诊断儿童急性阑尾炎。本研究的目的是确定使用CT是否对阴性阑尾切除术或穿孔率有任何影响。

方法

回顾一个对疑似急性阑尾炎患儿进行阑尾切除术的前瞻性数据库。通过与最终病理报告相关联来确定阴性阑尾切除术和穿孔率。

结果

连续85例患者因疑似急性阑尾炎接受了阑尾切除术。总体阴性阑尾切除术率为17.6%，女性为19.4%，男性为16.6%（p = 0.75）。CT的总体准确性、敏感性和阳性预测值分别为75%、91%和81%。接受CT检查的患者阴性阑尾切除术率（17.9%对19.3%，p > 0.99）或穿孔率（26%对17%；p = 0.53）没有显著降低。