顺逆旋转及顺逆旋转延伸加压超声扫查法结合Alvarado评分对急性阑尾炎的诊断价值

目的探讨顺逆旋转及顺逆旋转延伸加压超声扫查法结合Alvarado评分对急性阑尾炎的辅助诊断价值。方法参照Alvarado评分（简称“评分”），对我院超声科在2011年1～5月由急诊科医师拟诊为“急性阑尾炎”采用顺逆旋转及顺逆旋转延伸加压超声检查法的205例患者进行前瞻性分析。结果在本次研究拟诊为“急性阑尾炎”的205例中，有67例通过术后病理诊断确诊为阑尾炎，超声检查结合评分的准确率约为95．6％，灵敏度约为93．1％，特异性约为97．O％，阳性预测值94．4％，阴性预测值96．3％，关联系数为0．67，阴性阑尾切除率为5．97％。超声结合评分对急性阑尾炎的诊断结果如下：0～4分准确率为99．O％，灵敏度为91．7％，特异性为100％；5-6分准确率为88．6％，灵敏度为85．7％，特异性91.7％；7-8分准确率约为94．1％，灵敏度为97．1％，特异性为88．2％；9～10占准确率为100．O％，灵敏度为100．0％，特异性为100．0％。使用Pearsonx。检验，对顺逆旋转及顺逆旋转延伸加压超声扫查法结合Alvarado评分与临床最终诊断的关联性进行分析，其与临床最终诊断相关联，差异有统计学意义（x^2=167．31，P〈0．05）。结论顺逆旋转及顺逆旋转延伸加压超声扫查法结合Alvarado评分对急性阑尾炎的辅助诊断有一定的价值。

The value of ultrasonography in diagnosis of acute appendicitis incorporating the Alvarado scoring system in community hospital

Objective To determine the value of ultrasonography(US) incorporating the Alvarado scoring system in diagnosis of patients with suspected acute appendicitis.Methods Strategies to suggest which patients presenting to the emergency department(ED) should undergo US to confirm appendicitis have not been delayed.According to the Alvarado scoring system,a prospective study of 205 suspected appendicitis patients were evaluated by ED physicians and all undergone US in the US department to rule out appendicitis.We followed up patients’ progress of treatment and outcomes.Results About 67 patients were made the diagnosis of appendicitis through pathology by surgeons.The accuracy of US incorporating the Alvarado scoring system was 95.9%,the sensitivity 93.1% and the specificity 97.0%,the positive predictive value 94.4%,the negative predictive 96.3% and the association coefficiency 0.67.And the US incorporating the Alvarado scoring system was associated with the final diagnosis(P < 0.05).The negative appendectomy rate was 5.97%.The accuracy,sensitivity and specificity between 0-4 scores was 99.0%,91.7% and 100%;between 5-6 scores was 88.6%,85.7% and 91.3%;between 7-8 scores was 94.1%,97.1% and 88.2%;between 9-10 scores was 100.0%,100.0% and 100.0%.Conclusion US incorporating the Alvarado scoring system is an valuable method in diagnosis of acute appendicitis.