回顾性分析改良Alvarado评分系统在急性阑尾炎中的应用价值
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摘要
目的探讨改良Alvarado评分系统对急性阑尾炎诊断的应用价值。方法采用整群抽样的方法回顾性分析1 628例急性阑尾炎病人临床病理资料,应用改良Alvarado评分标准进行急性阑尾炎的诊断;分析评分结果与急性阑尾炎术后病理结果的相关性;计算灵敏度和特异度,并应用ROC曲线对结果进行分析评价。结果改良Alvarado评分系统评分结果与病理分级成正相关(r=0.7,P<0.001);急性阑尾炎病人的改良Alvarado评分在ROC曲线下的面积为0.956(95%CI为0.942—0.969,P<0.001);预测评分系统对急性阑尾炎的临床诊断临界点为6分时,其灵敏度为94.3%,特异度为87.4%。结论改良Alvarado评分系统对于急性阑尾炎诊断有一定的价值。
Objective To study the diagnostic value of modified Alvarado score system in acute appendicitis.Methods Clinical data from 1 628 cases having undergone an appendicectomy were retrospectively collected.A modified Alvarado score system was detected and its correlation with postoperative pathologic results was calculated. Results The rating score and pathological parting turned into a positive correlation(r=0.7, P <0.001). The areas under ROC curve of modified Alvarado score system were 0.943(95% CI, 0.929—0.958;P < 0.001). The clinical diagnostic critical points of the modified Alvarado score system was 6, with a sensitivity of 94.3% and specificity of 87.4%. Conclusion This modified Alvarado score system can be used effectively in supporting the diagnosis of acute appendicitis.
Objective To study the diagnostic value of modified Alvarado score system in acute appendicitis.Methods Clinical data from 1 628 cases having undergone an appendicectomy were retrospectively collected.A modified Alvarado score system was detected and its correlation with postoperative pathologic results was calculated. Results The rating score and pathological parting turned into a positive correlation(r=0.7, P <0.001). The areas under ROC curve of modified Alvarado score system were 0.943(95% CI, 0.929—0.958;P < 0.001). The clinical diagnostic critical points of the modified Alvarado score system was 6, with a sensitivity of 94.3% and specificity of 87.4%. Conclusion This modified Alvarado score system can be used effectively in supporting the diagnosis of acute appendicitis.
引文
[1]Shuaib A,Shuaib A,Fakhra Z,et al.Evaluation of modified Alvarado scoring system and RIPASA scoring system as diagnostic tools of acute appendicitis[J].World J Emerg Med,2017,8(4):276—280
[2]Sammalkorpi HE,Mentula P,Savolainen H,et al.The Introduction of Adult Appendicitis Score Reduced Negative Appendectomy Rate[J].Scand J Surg,2017,106(3):196—201
[3]Kalan M,Talbot D,Cunliffe WJ,et al.Evaluation of the modified Alvarado score in the diagnosis of acute appendicitis:a prospective study[J].Ann R Coll Surg Engl,1994,76(6):418—419
[4]Abou Merhi B,Khalil M,Daoud N.Comparison of Alvarado score evaluation and clinical judgment in acute appendicitis[J].Med Arh,2014,68(1):10—13
[5]宋炜强,赵海腾,陈其民,等.改良Alvarado评分系统与小儿阑尾炎术后病理的相关分析[J].中华小儿外科杂志,2004,25(2):110—111
[6]Al-Hashemy AM,Seleem MI.Appraisal of the modified Alvarado score for acute appendicits in adults[J].Saudi Med J,2004,25(9):1229—1231
[7]Khan I,Ur Rehman A.Application of alvarado scoring system in diagnosis of acute appendicitis[J].J Ayub Med Coll Abbottabad,2005,17(3):41—44
[8]张磊,李斌,陈茂盛,等.改良Alvarado评分系统与急性阑尾炎病理结果的相关性[J].兰州大学学报:医学版,2014,(2):73—75,80
[2]Sammalkorpi HE,Mentula P,Savolainen H,et al.The Introduction of Adult Appendicitis Score Reduced Negative Appendectomy Rate[J].Scand J Surg,2017,106(3):196—201
[3]Kalan M,Talbot D,Cunliffe WJ,et al.Evaluation of the modified Alvarado score in the diagnosis of acute appendicitis:a prospective study[J].Ann R Coll Surg Engl,1994,76(6):418—419
[4]Abou Merhi B,Khalil M,Daoud N.Comparison of Alvarado score evaluation and clinical judgment in acute appendicitis[J].Med Arh,2014,68(1):10—13
[5]宋炜强,赵海腾,陈其民,等.改良Alvarado评分系统与小儿阑尾炎术后病理的相关分析[J].中华小儿外科杂志,2004,25(2):110—111
[6]Al-Hashemy AM,Seleem MI.Appraisal of the modified Alvarado score for acute appendicits in adults[J].Saudi Med J,2004,25(9):1229—1231
[7]Khan I,Ur Rehman A.Application of alvarado scoring system in diagnosis of acute appendicitis[J].J Ayub Med Coll Abbottabad,2005,17(3):41—44
[8]张磊,李斌,陈茂盛,等.改良Alvarado评分系统与急性阑尾炎病理结果的相关性[J].兰州大学学报:医学版,2014,(2):73—75,80