Grebeldinger S
Institut za zdravstvenu zastitu dece i omladine, Medicinski fakultet, Novi Sad.
Med Pregl. 1996;49(11-12):487-91.
128 patients aged from 2 to 18 with symptoms of acute appendicitis were studied prospectively. Surgical procedure was performed in 58 patients (i.e. appendectomy). In 5 patients surgical findings were catarrhal inflammation, in 14 phlegmonous, in 9 gangrenous, in 15 perforated and in 13 no inflammation occurred. In 2 cases abscess periappendiceal was found intraoperatively. We considered as visualized only those appendices that were intraoperatively found at places ultrasonographically described. Ultrasonographic visualization was successful in 91.37%. The most relevant criteria for ultrasonic evaluation of the inflammation is noncompressibility noted in 97.67% of cases of appendicitis. The second criteria is thickened wall noted in 86.04% of patients. Ultrasonographic diagnosis of the abdominal fluid collections is confident: sensitivity 0.85, specificity 0.91. The diagnostic value of ultrasound findings in acute appendicitis is high: sensitivity 0.87, specificity 0.84. That is why routine ultrasound diagnostic examination in acute atypical appendicitis is recommended.
对128例年龄在2至18岁、有急性阑尾炎症状的患者进行了前瞻性研究。58例患者接受了手术治疗(即阑尾切除术)。手术发现5例为卡他性炎症,14例为蜂窝织炎,9例为坏疽,15例为穿孔,13例未发生炎症。术中发现2例阑尾周围脓肿。我们仅将术中在超声描述部位发现的阑尾视为可视化。超声可视化成功率为91.37%。超声评估炎症的最相关标准是不可压缩性,在97.67%的阑尾炎病例中可见。第二个标准是86.04%的患者出现肠壁增厚。超声对腹腔积液的诊断可靠:敏感性为0.85,特异性为0.91。超声检查结果在急性阑尾炎中的诊断价值较高:敏感性为0.87,特异性为0.84。因此,建议对急性非典型阑尾炎进行常规超声诊断检查。