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小儿急性阑尾炎：三种术前诊断方式的诊断准确性比较

Paediatric Acute Appendicitis: A Comparison of Diagnostic Accuracy of Three Pre-operative Diagnostic Modalities.

作者信息

Kalu Ukoha Agwu, Jones Taiwo, Fadahunsi Olufunke O, Ibiyeye Taiye T, Odi Temitope O, Abdur-Rahman Lukman Olajide

机构信息

Department of Surgery, Federal Medical Centre, Lokoja, Kogi State, Nigeria.

Department of Surgery, University of Ilorin Teaching hospital, Ilorin, Kwara State, Nigeria.

出版信息

J West Afr Coll Surg. 2022 Jul-Sep;12(3):89-95. doi: 10.4103/jwas.jwas_145_22. Epub 2022 Oct 6.

DOI:10.4103/jwas.jwas_145_22
PMID:36388732
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9641736/
Abstract

INTRODUCTION

The diagnosis of acute appendicitis (AA) is usually clear cut but sometimes there is atypical presentation of this condition in children. There is a need to determine and compare the diagnostic accuracy of these three pre-operative diagnostic modalities: Paediatric Appendicitis Score (PAS), abdominal ultrasonographic scan (USS) findings, and serum C-reactive proteins (CRPs). The objective of this study was to determine the diagnostic accuracy of the three diagnostic modalities and to compare each diagnostic test result with the histopathological results of the appendix specimens.

MATERIALS AND METHODS

This was a prospective cross-sectional study that involved children aged 4-15 years with suspected AA who presented at the emergency paediatric unit of a tertiary health care hospital in North Central, Nigeria. The PAS, quantitative serum CRP, and abdominal USS were performed for all eligible patients.

RESULTS

A total of 43 patients were included in this study. Forty appendicectomy specimens (93%) were histologically confirmed to be AA and three appendicectomy specimens (7%) were normal appendix. The diagnostic accuracy values of PAS, abdominal USS, and CRP were 95.3%, 93.0%, and 90.7%, respectively.

CONCLUSION

This study demonstrated that PAS, abdominal USS, and serum CRP provided useful diagnostic accuracy for AA in children.

摘要

引言

急性阑尾炎（AA）的诊断通常明确，但儿童有时会出现这种疾病的非典型表现。有必要确定并比较这三种术前诊断方法的诊断准确性：小儿阑尾炎评分（PAS）、腹部超声扫描（USS）结果和血清C反应蛋白（CRP）。本研究的目的是确定这三种诊断方法的诊断准确性，并将每项诊断测试结果与阑尾标本的组织病理学结果进行比较。

材料与方法

这是一项前瞻性横断面研究，纳入了尼日利亚中北部一家三级医疗保健医院急诊儿科病房疑似患有AA的4至15岁儿童。对所有符合条件的患者进行了PAS、血清CRP定量检测和腹部USS检查。

结果

本研究共纳入43例患者。40例阑尾切除标本（93%）经组织学证实为AA，3例阑尾切除标本（7%）阑尾正常。PAS、腹部USS和CRP的诊断准确性值分别为95.3%、93.0%和90.7%。

结论

本研究表明，PAS、腹部USS和血清CRP对儿童AA具有有用的诊断准确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c4e/9641736/a5d5a1eb85b2/JWACS-12-89-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c4e/9641736/554a8d41eed7/JWACS-12-89-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c4e/9641736/3145d42e0c57/JWACS-12-89-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c4e/9641736/e43715d26664/JWACS-12-89-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c4e/9641736/a5d5a1eb85b2/JWACS-12-89-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c4e/9641736/554a8d41eed7/JWACS-12-89-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c4e/9641736/3145d42e0c57/JWACS-12-89-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c4e/9641736/e43715d26664/JWACS-12-89-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c4e/9641736/a5d5a1eb85b2/JWACS-12-89-g005.jpg

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