目的 分析经腹部浅表超声检查对急性阑尾炎患者检出率的影响。方法 选取濮阳市人民医院2018年12月—2020年6月疑似急性阑尾炎患者146例,均行腹部超声、浅表超声检查,以术后诊断为金标准,比较腹部、浅表超声单独及联合诊断效能、对不同类型急性阑尾炎检出率,分析不同类型急性阑尾炎影像学结果。结果 以术后诊断为金标准,146例疑似急性阑尾炎患者中阳性87例,阴性59例;腹部超声检出阳性80例,阴性66例;浅表超声检出阳性91例,阴性55例;腹部浅表超声检出阳性86例,阴性60例;腹部浅表超声诊断急性阑尾炎准确度99.32%(145/146)、灵敏度98.85%(86/87)、特异度100.00%(59/59)高于腹部超声[70.55%(103/146)、71.26%(62/87)、69.49%(41/59)]及浅表超声[69.86%(102/146)、77.01%(67/87)、59.32%(35/59)]单独诊断,漏诊率1.15%(1/87)、误诊率0.00%(0/59)低于腹部超声[28.74%(25/87)、30.51%(18/59)]及浅表超声[22.99%(20/87)、40.68%(24/59)]单独诊断(P＜0.05);腹部浅表超声对不同类型急性阑尾炎总检出率高于单独检查(P＜0.05)。结论 腹部浅表超声应用于急性阑尾炎诊断,可提高诊断准确度、灵敏度、特异度,降低漏诊率及误诊率,对不同类型急性阑尾炎检出率提高有积极作用,可收集患者详细声像信息,为临床治疗方案制定提供方向。

目的 探讨急性阑尾炎(acute appendicitis, AA)及急性感染性肠炎(acute infectious enteritis, AIE)患儿的阑尾高频超声影像特点及其显像敏感性。方法 回顾性分析临床确诊为急性阑尾炎患儿120例,急性感染性肠炎患儿160例,并对其行高频超声检查,另设120例正常儿童为对照组。分析高频超声阑尾显示率,阑尾外径,阑尾周围系膜炎性变化以及阑尾的位置等情况。结果 AA组、AIE组、对照组阑尾的显示率分别为96.7%、80.6%、68.3%,差异有统计学意义(P<0.05)。三组超声显示的阑尾外径分别为(8.5±2.2)mm、(4.3±0.8)mm、(3.5±0.7)mm,相互间差异亦均有统计学意义(P<0.05)。AA组所有的阑尾周围系膜炎症改变均可探及,但AIE组的阑尾周围系膜无变化。结论 小儿急性阑尾炎高频超声显像敏感性高,旨在为临床对AA早期诊断、早期治疗提供较准确全面的影像学依据。

Objective Use high-frequency ultrasound to determine the frequency of visualization and image feature of the appendix in children with acute appendicitis (acute appendicitis, AA) and with acute infectious enteritis (acute infectious enteritis, AIE). Methods The ultrasonic features of 120 children with AA, 160 children with AIE, and 120 randomly selected asymptomatic children were analyzed retrospectively. And their visualization rate, outer appendiceal diameter, presence or absence of inflamed periphery appendiceal mesenterium, and location of the appendix were recorded. Results The visualization rates of the appendix were 96.7%, 80.6%, and 68.3% for AA groups, AIE groups, and the control, respectively(P<0.05). The outer appendiceal diameters for the 3 groups were (8.5±2.2)mm, (4.3±0.8)mm, and (3.5±0.7)mm. Difference among the 3 groups was statistically significant also. Periphery appendiceal inflamed mesenterium was detected in all AA cases, but in none of the AIE cases. Conclusion High ultrasound imaging sensitivity of puerile acute appendicitis provided relatively accurate comprehensive imaging basis for clinical early diagnosis and early treatment.