改良Alvarado评分系统与小儿阑尾炎术后病理的相关分析

目的　为探讨改良Alvarado评分系统与小儿急性阑尾炎术后病理结果的相关关系 ,以及在小儿急性阑尾炎诊断中的应用。方法　评估上海第二医科大学附属新华医院上海儿童医学中心外科 2 0 0 1年 1月至 2 0 0 3年 6月间收治 ,拟诊急性阑尾炎并施行阑尾切除术的 2 4 8例患儿临床资料 ,对Alvarado系统评分结果与病理诊断进行分析。结果　评分系统与病理分级呈正相关 (r =0 .4 30 ,P<0 .0 1) ;在预测进展型病理的阑尾炎病例时 ,评分系统的灵敏度为 82 .3% ,特异度为 77.0 %。结论　提示改良Alvarado评分系统在早期诊断小儿急性阑尾炎与确定外科手术治疗 ,减少非必要性急诊手术率和穿孔的危险上有重要价值。

Analysis of modified alvarado scoring system and its correlation with pathological grades of acute appendicitis in children

Objective To evaluate the application of the modified Alvarado scoring system in childhood acute appendicitis(aA),and its correlation with pathological grades. Methods The data of 248 patients who had undergone appendectomy from Jan 2001 to June 2003 in Shanghai Children's Medical Center were analyzed. Statistical methods used included correlation analysis,variance analysis and run test. Results The scores correlated positively with pathological grades (r= 0.430, P< 0.01). When the score was used for predicting aA with advanced pathological grades, the sensitivity and specificity of the Alvarado scoring system were 82.3% and 77.1% respectively. Conclusions It shows that the modified Alvarado scoring system is useful in early childhood aA for making the diagnosis and decision for surgical treatment. Its application can reduce unnecessary surgery and risks of perforation or abscess formation.