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确定RIPASA评分在疑似急性阑尾炎诊断中的有效性及其与组织病理学的相关性,并评估其在印度人群中的适用性:一项单机构研究

To Determine Validation of RIPASA Score in Diagnosis of Suspected Acute Appendicitis and Histopathological Correlation with Applicability to Indian Population: a Single Institute Study.

作者信息

Singh Amit, Parihar Ummed Singh, Kumawat Ghanshyam, Samota Ramjilal, Choudhary Ramjas

机构信息

J.L.N Medical College, Ajmer, Rajasthan India.

出版信息

Indian J Surg. 2018 Apr;80(2):113-117. doi: 10.1007/s12262-018-1731-6. Epub 2018 Feb 2.

Abstract

Although acute appendicitis is one of the most common surgical emergencies worldwide, timely accurate diagnosis is always difficult for a surgeon even after availability of recent diagnostic tools. Our study is to determine validation of RIPASA score in diagnosis of acute appendicitis and histopathological correlation. A prospective study of 200 patients presented to emergency or surgical opd with right iliac fossa pain and suspected to have acute appendicitis were included in our study. RIPASA score calculated but appendectomy done on the basis of clinical assessment and hospital protocol and histopathological correlation done with a score. A score of 7.5 is cut off threshold, results compared with previous studies. In our study of 200 patients, M:F ratio of 1.56:1. Sensitivity of the RIPASA score was 95.89℅ with specificity 75.92% and diagnostic accuracy of 90.5%, expected and observed rate of negative appendectomy were 8.5 and 12.35%, respectively. So there is net reduction in negative appendectomy rate by 3.85%. Data analysis done with Statistical Package for Social Science (SPSS) version 21.0. RIPASA score at a cutoff value of 7.5 is easier, cheap, and better diagnostic tool in equivocal case of right iliac fossa pain in Indian scenario of limited availability of recent diagnostic tool in remote areas and affordability of these tool in the available set up, simultaneously, it also helps to reduce negative appendectomy rates.

摘要

尽管急性阑尾炎是全球最常见的外科急症之一,但即便有了最新的诊断工具,外科医生要及时准确地做出诊断仍颇具难度。我们的研究旨在确定RIPASA评分在急性阑尾炎诊断中的有效性及其与组织病理学的相关性。本研究纳入了200例因右下腹疼痛就诊于急诊科或外科门诊且疑似患有急性阑尾炎的患者。计算RIPASA评分,但阑尾切除术是根据临床评估和医院规程进行的,并将组织病理学结果与该评分进行关联。以7.5分为截断阈值,将结果与先前的研究进行比较。在我们对200例患者的研究中,男女比例为1.56:1。RIPASA评分的敏感性为95.89%,特异性为75.92%,诊断准确性为90.5%,阴性阑尾切除术的预期发生率和实际发生率分别为8.5%和12.35%。因此,阴性阑尾切除术的发生率净降低了3.85%。使用社会科学统计软件包(SPSS)21.0版进行数据分析。在印度偏远地区近期诊断工具可用性有限且现有设备中这些工具费用可承受的情况下,对于右下腹疼痛的可疑病例,截断值为7.5的RIPASA评分是一种更简便、便宜且诊断效果更好的工具,同时,它还有助于降低阴性阑尾切除术的发生率。

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本文引用的文献

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The epidemiology of appendicitis and appendectomy in the United States.美国阑尾炎及阑尾切除术的流行病学
Am J Epidemiol. 1990 Nov;132(5):910-25. doi: 10.1093/oxfordjournals.aje.a115734.
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Appendicitis and mimicking conditions. A prospective study.
Lancet. 1975 Sep 6;2(7932):421-4. doi: 10.1016/s0140-6736(75)90841-7.

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