儿童急性阑尾炎诊断评分法的制定和初步应用

目的 建立一种诊断性评分法在术前应用，以提高儿童急性阑尾炎诊断的准确性。方法 回顾性分析研究1998年1月～2000年6月于我科行阑尾切除术的860例患者(年龄2～14岁，平均8．2岁)的临床资料，以确认有助于区分急性阑尾炎和假性阑尾炎的指标，并对这些临床资料进行统计学分析。结果 确认7项有诊断意义的指标，以贝叶斯概率对之进行评分，并利用ROC曲线找到诊断临界分值，从而建立诊断性评分系统。应用该评分法对我科2000年9月～2001年2月的107例患者术前评分，证实该法具有较高的灵敏度和特异度。结论 本研究建立的评分法对于提高儿童急性阑尾炎的诊断准确性及降低不必要的手术治疗有一定的帮助。

Establishment and Preliminary Application of Scoring System to Aid in Diagnosis of Acute Appendicitis in Children

Objective To establish a scoring system and to applicate it in the preoperative diagnosis of acute appendicitis in children. Methods Clinical data of 860 patients (from 2 years to 14 years old, average 8.2 years) who had undergone appendicectomy from Jan, 1998 to June, 2000 in our department were collected to identify attributes of distinguishing patients with pseudo appendicitis from those with acute appendicitis. The data was analysed by statistical methods. Results seven items criterions of diagnostic significance were confirmed ,then their value was scored by Baysian Probability and a cut-off point was abtained by using receiver-operator characteristic curve to establish a diagnosis scoring system. The scoring system was applicated prospectively to 107 patients hospitalized( from 3 years to 14 years old, average 7.8 years) from Sep, 2000 to Feb, 2001 and got a high sensitivity and specificity. Conclusions the scoing system established in this study could provide help in clinical diagnosis of acute appendicitis in children could reduce the rate of unnecessary emergency surgery.