| 刘建新,陈勇,赵珊珊,张文君.超声鉴别儿童穿孔与非穿孔性阑尾炎[J].中国医学影像技术,2014,30(7):1050~1053 |
| 超声鉴别儿童穿孔与非穿孔性阑尾炎 |
| Ultrasonography in differentiating perforated and nonperforated appendicitis in pediatric patients |
| 投稿时间：2013-11-28 修订日期：2014-05-20 |
| DOI： |
| 中文关键词: 儿童 阑尾炎 穿孔 超声检查 |
| 英文关键词:Child Appendicitis Perforation Ultrasonography |
| 基金项目: |
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| 中文摘要: |
| 目的 评价超声鉴别儿童阑尾炎是否穿孔的价值。方法 收集有明确病理结果的急性阑尾炎患儿193例，所有患儿均在手术治疗前接受超声检查。超声观察并记录阑尾最大直径、脓肿、阑尾腔内结石、阑尾黏膜下层、腹腔游离液体、阑尾周围脂肪组织等。以手术所见为标准、判断是否存在阑尾穿孔。分析超声各指标鉴别阑尾是否穿孔的价值，评判其特异度和敏感度。结果 <9岁患儿阑尾穿孔率（24/39，61.54%）远高于≥9岁患儿（52/154，33.77%；χ2=10.05，P=0.002）。提示阑尾穿孔意义较大的超声指标包括脓肿形成[敏感度38.16%（29、76，特异度99.15%（116、117）]<9岁患儿阑尾黏膜下层缺失[敏感度100%（24/24），特异度66.67%（8/12）]及阑尾腔内结石[敏感度90.91%（20/22），特异度77.00%（9/12）]。结论 超声对于鉴别儿童阑尾炎是否穿孔有较高价值。 |
| 英文摘要: |
| Objective To explore the value of ultrasound in differentiating perforated and nonperforated appendicitis in pediatric children. Methods Data of 193 acute appendicitis children proved by pathology were collected. The diameter of appendix, abscess, appendicolith, chogenic submucosal layer of appendix, free fluid in the abdomen as well as echogenic fat around the appendix were all observed with ultrasound. Surgical operation findings were taken as the standards for determining whether there was perforation or not. The significances, specificity and sensitivity of ultrasonic findings for differentiation perforated and nonperforated appendicitis were observed. Results The rate of appendiceal perforation was significantly higher in children younger than 9 years (24/39, 61.54%) compared with ≥9 years old children (52/154, 33.77%; χ2=10.05, P=0.002). Ultrasonic findings indicating appendiceal perforation included abscess (sensitivity 38.16% , specificity 99.15%[116/117]), loss of echogenic submucosal layer of appendix (sensitivity 100%[29/76], specificity 66.67%[8/12]) and presence of appendicolith in children younger than 9 years (sensitivity 90.91%[20/22], specificity 75.00%[9/12]). Conclusion Ultrasound has important value in differentiating perforated and nonperforated appendicitis in pediatric patients. |
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