即时超声检查对小儿肠套叠的诊断准确性：系统评价和荟萃分析。
Diagnostic accuracy of point-of-care ultrasonography for intussusception in children: A systematic review and meta-analysis.
机构信息
Department of Emergency Medicine and Department of Pediatrics, University of California, San Francisco, CA, United States of America.
Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, United States of America.
出版信息
Am J Emerg Med. 2022 Aug;58:255-264. doi: 10.1016/j.ajem.2022.06.025. Epub 2022 Jun 15.
OBJECTIVES
Ileocolic intussusception can be challenging to diagnose due to vague complaints, but rapid diagnosis and treatment can help prevent morbidity and mortality. Prior research has focused on radiologic ultrasound, with more recent studies focusing on point-of-care ultrasonography (POCUS). This systematic review and meta-analysis assesses the diagnostic accuracy of POCUS for children with suspected ileocolic intussusception.
METHODS
PubMed, Embase, CINAHL, LILACS, the Cochrane databases, Google Scholar, conference abstracts, and bibliographies of selected articles were searched for studies evaluating the accuracy of POCUS for the diagnosis of intussusception in children. Data were dual extracted into a predefined worksheet, and quality analysis was performed with the QUADAS-2 tool. Data were summarized, and a meta-analysis was performed.
RESULTS
Eleven studies (n = 2400 children) met our inclusion criteria. Overall, 14.4% of children had intussusception. POCUS was 95.1% (95% CI: 90.3% to 97.2%) sensitive and 98.1% (95% CI: 95.8% to 99.2%) specific with a positive likelihood ratio of 50 (95% CI: 23 to 113) and a negative likelihood ratio of 0.05 (95% CI: 0.03 to 0.09).
CONCLUSIONS
POCUS has excellent diagnostic accuracy for intussusception in children presenting to the emergency department.
目的
由于症状模糊，回肠-结肠型肠套叠的诊断具有挑战性，但快速诊断和治疗有助于预防发病率和死亡率。先前的研究集中在放射超声上，最近的研究则集中在即时护理超声（POCUS）上。本系统评价和荟萃分析评估了 POCUS 对疑似回肠-结肠型肠套叠儿童的诊断准确性。
方法
在 PubMed、Embase、CINAHL、LILACS、Cochrane 数据库、Google Scholar、会议摘要以及选定文章的参考文献中搜索评估 POCUS 对儿童肠套叠诊断准确性的研究。将数据双录入到预定义的工作表中，并使用 QUADAS-2 工具进行质量分析。对数据进行总结，并进行荟萃分析。
结果
符合纳入标准的研究共有 11 项（n=2400 名儿童）。总体而言，14.4%的儿童患有肠套叠。POCUS 的敏感度为 95.1%（95%CI：90.3%至 97.2%），特异度为 98.1%（95%CI：95.8%至 99.2%），阳性似然比为 50（95%CI：23 至 113），阴性似然比为 0.05（95%CI：0.03 至 0.09）。
结论
POCUS 对就诊于急诊科的儿童肠套叠具有出色的诊断准确性。
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