摘要
目的探讨提高小儿呼吸道异物术前诊断率的方法及其对治疗的意义。方法选取357例怀疑呼吸道异物的患儿,将诊断中常用的异物呛咳史、肺部体征、胸透3项指标,利用logistic回归分析及ROC曲线,确定呛咳史为核心指标,评分分值:有呛咳史者3分,体征阳性者2分,胸透阳性者3分,诊断的界限值4分。结果根据此评分,将357例患儿3个指标重新量化分析,3项指标之和大于界限值4分316例,气管异物阳性292例,阳性预测值为92.4%;小于4分41例,气管异物阴性34例,阴性预测值为82.9%。将此评分用于基层医院验证,提高了气管异物的诊断符合率。结论异物呛咳史对诊断气管异物作用最大。确定诊断指标评分,可以采取相应治疗方法,减少有创性检查。
OBJECTIVE To improve the preoperative diagnositic rate of tracheobronchial foreign bodies aspiration（TFB） in children and determine the effect on treatment. METHODS The 357 children who were suspected of having TFB were evaluated. A history of foreign body aspiration, physical examination findings and radiographic findings were the three diagnostic criteria. Logistic Regression Analysis and ROC curve were used to analyze the results. The history of foreign body aspiration was considered as the diagnositic standard. In developing a standardized scoring system a history of foreign body aspiration was assigned 3 points, positive physical examination 2 points and positive radiographic findings 3 points, and the threshold value of 4 points was chosen. RESULTS According to the score, the 357 cases were renewed to analyse. The total score exceeded 4 points in 316 cases. In this group, foreign bodies were found in 292 cases, for a positive diagnostic rate of 92.4%. In 41 cases with a score of less than 4 points, no foreign bodies were found in 34 cases, for a negative diagnostic rate of 82.9%. When this scoring system was used in other hospitals, the diagnostic rate of TFB was improved. CONCLUSION A history of foreign body aspiration was found to be the most important element in the diagnosis of TFB. A standardized scoring system with a predetermined threshold value was found to be valuable in choosing the best treatment to avoid unnecessary surgery.
出处
《中国耳鼻咽喉头颈外科》
北大核心
2009年第5期277-279,共3页
Chinese Archives of Otolaryngology-Head and Neck Surgery
基金
首都医学发展科研基金(2005-3024
2005-1032)
北京教育科技发展面上项目(KM200610025018)联合资助
关键词
异物
气管
支气管
儿童
诊断
参考标准
研究设计
Foreign Bodies
Trachea
Bronchi
Child
Diagnosis
Reference Standards
Research Design
