小儿疑似阑尾炎患者术中超声(USG)检查结果的准确性

Hari Irawan, E. Fikri, E. R. Daulay
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摘要

背景与目的:不明原因的下腹部疼痛可能使临床医生在诊断小儿阑尾炎时感到困惑。超声检查作为一种最初的负担得起的工具,已经了解到它在减少不必要的阑尾切除术中的作用。本研究旨在通过组织病理学结果确定小儿急性阑尾炎超声检查的准确性及其与术中表现的相关性。该结果将验证其他研究经验。方法:本研究是一项诊断性研究,回顾性分析2014年1月至2019年3月期间在北苏门答腊省棉兰市hajiam Malik医院和Universitas sumata Utara医院儿科外科接受疑似阑尾炎超声检查的儿童。我们用计算公式确定超声(USG)结果的准确性、灵敏度和特异性。超声检查结果与术中表现比较,采用卡方检验。结果:32例患者中男女比例基本为1:1,平均年龄14.06(±3.98)岁。超声诊断为阑尾组织26例。仅有2例患者术中未见阑尾炎,经组织病理学证实。超声检查结果与组织病理学检查结果差异有统计学意义(p= 0.03)。超声对阑尾炎的预测准确率为87.5%,敏感性86.7%,特异性100%。结论:我们的研究结果与其他研究相比是有利的,但是表明了图像准确性的改进潜力,未来的研究将采用新的超声发现分类方法。
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Accuracy of Findings of Ultrasound (USG) Examination in Pediatric Patients with suspected Appendicitis with Intraoperative Findings
Background & Objectives: Unspecified lower abdominal pain might confuse clinicians in diagnosing pediatric appendicitis. Ultrasonography, as an initial affordable tool, has been learned its role in reducing unnecessary appendectomy. This study aimed to determine the accuracy of ultrasonography in pediatric acute appendicitis and its correlation to intraoperative findings, confirmed by histopathology results. The result would verify other study experience. Methods : The study was a diagnostic study which retrospectively review the children who underwent an ultrasound study for suspected appendicitis in pediatric surgery division of Haji Adam Malik Hospital and Universitas Sumatera Utara Hospital, Medan, North Sumatera between January 2014 until March 2019. We determined the accuracy along with sensitivity and specificity results of Ultrasonography (USG) using calculated formula. The comparation between ultrasonography results and intraoperative findings was analyzed using Chi Square test or its alternative. Results : Among the 32 patients, male and female were almost equal in 1:1 ratio, with mean age of 14.06 (±3.98) years old. Twenty-six patients were positively diagnosed as appendicitis using ultrasonography. Only two patients have no appendicitis based on intraoperative findings, confirmed by histopathology results. There is a statistically significant difference between ultrasonography findings and histopathology results (p=0,03). We obtained the accuracy of ultrasonography in predicting appendicitis was 87.5%, with 86.7% sensitivity and 100% specificity. Conclusion : Our results compare favorably with alternative studies, however indicate the potential for improvement in accuracy of image, with a future study incorporating new ways of categorizing ultrasound findings presently being undertaken.
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