阑尾炎CT评分在部队急性阑尾炎患者中的应用价值

 目的 探讨阑尾炎CT评分(CTAS)在部队急性阑尾炎(AA)患者中的应用价值。方法 通过参考文献和调查研究制定CTAS系统。调取2018-09至2019-08 35例部队AA患者CT检查资料作为AA组;随机抽取同期35例非阑尾炎(NA)部队官兵腹部CT检查资料作为NA组。回顾性分析两组资料并分别记录其CTAS,了解两组间CTAS差异;根据预测AA的受试者操作特性曲线(ROC曲线)和约登指数(YI)确定最佳截断点,了解CTAS诊断AA的效能。结果 AA组评分均值(5.91±1.90),NA组评分均值(1.51±1.27),组间评分差异有统计学意义(P=0.001)。AA组内不同病理分型评分差异有统计学意义(P=0.001),CTAS越高预示着病变越严重。诊断AA最佳截断点CTAS=3.5(即CTAS≥4时可诊断为AA),敏感性为91.40%,特异性为94.30%,准确率为92.86%。结论 CTAS诊断部队AA患者时,分值≥4分的诊断效能高,有较高临床应用价值。

Applicability of CT appendicitis scores in military patients with acute appendicitis

Objective To explore the applicability of the CT appendicitis score(CTAS) in military patients with acute appendicitis(AA). Methods A CTAS system was established through literature review and investigation. The CT examination data on 35 military patients with AA treated between September 2018 and August 2019 served as the AA group, while the CT examination data of 35 non-appendicitis military cases was randomly selected as the non-appendicitis (NA) group. The data on the two groups was retrospectively analyzed and their CTASs were recorded to reveal the difference between the two groups. The optimal cut-off point was determined based on the receiver operating characteristic curve (ROC curve) and the Youden Index (YI) to find out about the efficacy of the CTAS in diagnosing AA. Results The mean score of the AA group was 5.91±1.90, compared with 1.51±1.27 for the NA group, showing significant difference (P=0.001).There were statistically significant differences in the scores of different pathological types in AA group (P=0.001). The higher the CTAS was, the more serious the lesion was. The optimal cut-off point for AA diagnosis was CTAS=3.5(i.e., AA could be diagnosed when CTAS≥4), with a sensitivity of 91.40%, specificity of 94.30% and accuracy of 92.86%. Conclusions When the CTAS is used to diagnose military AA patients, the diagnostic efficiency is high with CTAS≥4.