超声在急性阑尾炎临床分型中的价值

目的探讨超声在诊断急性阑尾炎临床分型中的价值。方法回顾性分析186例经术后病理证实为急性阑尾炎患者的术前超声图像,对炎症进行分期。用Kappa检验评价超声与病理检查的一致性。结果 186例急性阑尾炎患者,其中单纯性阑尾炎55例,超声检出34例（61.82%）,Kappa值为0.613;化脓性阑尾炎84例,超声检出77例（91.67%）,Kappa值为0.891;坏疽性阑尾炎29例,超声检出28例（96.55%）,Kappa值为0.980;阑尾周围脓肿18例,超声检出18例（100%）,Kappa值为1.000。结论对于单纯性阑尾炎超声与病理诊断结果一致性一般,对于化脓性阑尾炎、坏疽性阑尾炎、阑尾周围脓肿超声与病理诊断结果一致性较好,超声在确定急性阑尾炎临床分型中有重要价值。

The Value of the Ultrasonic Diagnosis of Clinical Classification of Acute Appendicitis

【Objective】 To investigate the value of the ultrasonic diagnosis of clinical classification of acute appendicitis.【Methods】 Sonographic appearance about 186 patients with acute appendicitis,which were attested by surgery and pathology were retrospectively studied to confirm the clinical stage.The consistency of ultrasonography and pathology were analyzed by Kappa test.【Results】 Among the 186 patients,simple appendicitis were 55,34（61.82%）were found by ultrasonography,the consistency test Kappa value was 0.613.Suppurative appendicitis were 84,77（91.67%） were found by ultrasonography,the consistency test Kappa value was 0.891.Gangrenous appendicitis were 29,28（96.55%）were found by ultrasonography,the consistency test Kappa value was 0.980.Appendiceal abscess were 18（100%） which were all found by ultrasonography,the consistency test Kappa value was 1.000.【Conclusion】 Ultrasonnography have general consistency in the diagnosis of simple appendicitis and good consistency with pathology in the diagnosis of suppurative appendicitis 、gangrenous appendicitis and appendiceal abscess.So ultrasonography had important clinical value to confirm the clinical classification of acute appendicitis.