超声对儿童急慢性阑尾炎的鉴别诊断价值

摘要

目的 研究超声对儿童急慢性阑尾炎的鉴别诊断价值.方法 采用随机选取法选取本院2014年5月至2016年5月经确诊为阑尾炎的患儿98例,在行阑尾切除术之前对所有患者均行CT和超声检查,两种方法对儿童急慢性阑尾炎诊断的灵敏度及急性阑尾炎中单纯性阑尾炎和非单纯性阑尾炎诊断的灵敏度比较.结果 在诊断非单纯性阑尾炎时,CT检查灵敏度88.9％和超声检查的灵敏度85.2％相差不大,差异无统计学意义(P＞0.05);在诊断慢性阑尾炎时,CT检查灵敏度75.0％和超声检查的灵敏度50.0％比较,差异无统计学意义(P＞0.05);在诊断单纯性阑尾炎时,CT检查的灵敏度89.3％,明显高于超声检查的灵敏度50.0％,差异有统计学意义(P＜0.05).结论 影像学是临床上诊断儿童急慢性阑尾炎的重要手段之一,而CT的诊断价值高于超声,但是CT扫描会大大的增加儿童的一些组织发生癌变而产生恶性肿瘤,因此在临床上诊断儿童急慢性阑尾炎的首选手段还是超声检测,只是当出现了超声也无法确认的病变或发现可疑的结果时,可建议再行CT检测.%Objective To investigate the value of ultrasonography in differential diagnosis children with acute or chronic appendicitis.Methods 98 children with appendicitis were randomly selected from our hospital from May,2014 to May,2016,and were examined by CT an ultrasound before surgery.The sensitivities in the diagnosis of acute and chronic appendicitis and in simple and non-simple appendicitis by these two methods were compared.Results In the diagnosis of non-simple appendicitis,the sensitivity by CT was 88.9％,and that by ultrasound 85.2％,with no statistical difference (P＞0.05).In the diagnosis of chronic appendicitis,the sensitivity by CT was 75.0％,and that by ultrasonography 50.0％,with no statistical difference (P＞0.05).In the diagnosis of simple appendicitis,the sensitivity by CT was significantly higher than that by ultrasound (89.3％ vs.50.0％,P＜0.05).Conclusion Iconography is one of the important means in the diagnosis of children with acute or chronic appendicitis;and the diagnostic value of CT scanning is higher than that of ultrasound,but CT greatly increases the incidence of cancer in children.Therefore,the first choice for diagnosing acute and chronic appendicitis in children is ultrasonic,but if the ultrasound can not make a confirmation,CT detection is recommended.