改良Alvarado评分系统与婴幼儿阑尾炎术后病理相关性分析

目的 ：探讨改良Alvarado评分系统与婴幼儿阑尾炎术后病理的相关性，为婴幼儿阑尾炎诊断提供依据。方法：回顾性分析本科室自2008年1月至2013年3月间120例4岁以下阑尾炎手术患儿的临床资料，以阵发性哭吵或腹痛及腹胀压痛代替转移性腹痛及右下腹压痛进行改良评分，并对Alvarado系统评分结果与病理诊断进行分析。结果：120例患儿资料经改良Alvarado评分系统判断，与病理分级呈正相关（r=0.39，P＜0.01）；在预测进展型病理阑尾炎病例时，评分系统灵敏度为96.5%，准确度为92.5%。结论：改良Alvarado评分系统主要针对婴幼儿阑尾炎的临床表现，包括病史和体检等，对有效提高婴幼儿阑尾炎诊断的准确率，减少穿孔危险上有重要价值。

Analysis of modified Alvarado scoring system and its correlation with pathological grades of acute appendicitis in infants

Objective: To explore the application of the modified Alvarado scoring system in infant acute appendicitis, and provide the diagnostic basis to infant appendicitis. Methods: The clinical data of 120 cases of infants who had undergone appendectomy form 2008 to 2013 in the Department of Pediatric Surgery of Yuying Children’s Hospital Affiliated to Wenzhou Medical University were analyzed retrospectively. We used paroxysmal crying abdominal pain and bloating instead of migration of pain and right lower quadrant tenderness, and analyzed the results of Alvarado scoring system with pathological diagnosis. Results: The scores of 120 cases of infants correlated positively with pathological grades (r=0.39, P<0.01). And the sensitivity and accuracy of the Alvarado scoring system were 96.5% and 92.5% respectively, when we used the score for predicting infants acute appendicitis with the advanced pathological grades. Conclusion: It shows that the modified Alvarado score system is mainly aimed at the clinical manifestations, including medical history and physical examination, etc. And it is useful in infant appendicitis for improving diagnosis accuracy and reducing the risks of perforation.