摘要
目的 探讨凸阵联合线阵探头超声技术在急性阑尾炎不同分型鉴别诊断中的应用价值。方法 回顾性收集2020年3月至2025年4月郑州市中医院行外科手术治疗的70例急性阑尾炎患者临床资料,所有患者术前均行凸阵联合线阵探头超声技术检查,以临床综合检查确诊结果作为金标准,分析凸阵联合线阵探头超声技术对急性阑尾炎分型的鉴别诊断效能。结果 手术结果证实,70例急性阑尾炎患者中,25例为单纯性急性阑尾炎,45例为复杂性急性阑尾炎(化脓性30例,坏疽性及穿孔性10例、阑尾周围脓肿5例)。经凸阵联合线阵探头超声技术诊断单纯性、化脓性、坏疽性及穿孔性阑尾炎、阑尾周围脓肿符合率依次为92.0%(23/25)、86.7%(26/30)、80.0%(8/10)、80.0%(4/5),组间比较差异无统计学意义(P>0.05)。4种类型阑尾直径比较,差异有统计学意义(F=63.776,P<0.001);4种类型阑尾炎周围积液依次呈“无积液、局限性、弥漫性、包裹性”的特征;单纯性、化脓性、坏疽性及穿孔性阑尾炎黏膜中断发生率比较,差异有统计学意义(χ^(2)=38.958,P<0.001)。复杂的3种类型管壁状态依次呈“结构清晰、增厚模糊、结构消失”特征。凸阵联合线阵探头超声技术鉴别分型的总体准确率为87.1%(61/70),与金标准一致性高(Kappa值=0.808,P<0.001);且该技术对不同急性阑尾炎类型诊断的特异性、阳性预测值、准确率比较,差异有统计学意义(P<0.05),其对单纯性阑尾炎和阑尾周围脓肿的诊断特异性及阳性预测值均达100%。结论 凸阵联合线阵探头超声技术对急性阑尾炎分型鉴别诊断整体效能较好,尤其对单纯性阑尾炎及阑尾周围脓肿的诊断价值较高。
Objective To explore the application value of convex array combined with linear array probe ultrasound technology in the differential diagnosis of different subtypes of acute appendicitis.Methods A retrospective collection of clinical data was conducted on 70 patients with acute appendicitis who underwent surgical treatment at Zhengzhou Traditional Chinese Medicine Hospital from March 2020 to April 2025.All patients underwent preoperative convex array combined with linear array probe ultrasound technology examination.The diagnostic results of clinical comprehensive examination were used as the gold standard to analyze the differential diagnostic efficacy of convex array combined with linear array probe ultrasound in the classifying acute appendicitis.Results The surgical results confirmed that 25 cases were simple acute appendicitis and 45 cases were complex acute appendicitis(30 cases were suppurative,10 cases were gangrenous and perforated,and 5 cas-es were with periappendiceal abscess).The diagnostic accuracy rates for simple,suppurative,gangrenous,and perforated appendicitis,as well as appendiceal abscess,using convex array combined with linear array probe ultrasound technology were 92.0%(23/25),86.7%(26/30),80.0%(8/10),and 80.00%(4/5),respectively,with no statistical significant difference between the groups(P>0.05).There was a statistically significant difference in the diameter of the four types of appendices(F=63.776,P<0.001).The characteristics of surrounding fluid accumu-lation were classified as"no fluid,localized,diffuse,and encapsulated"for the four types of appendicitis.The incidence of mucosal disruption in simple,suppurative,gangrenous,and perforated appendicitis showed statis-tically significant differences(χ^(2)=38.958,P<0.001).The states of the pipe wall were categorized as"clear structure,thickening and blurring,and disappearance of structure",respectively.The overall accuracy of convex array com-bined with linear array probe ultrasound in classifying acute appendicitis was 87.1%(61/70),with high consis-tentency to the gold standard(Kappa value=0.808,P<0.001).Moreover,the specificity,positive predictive value,and accuracy of this technology for the diagnosis of different types of acute appendicitis showed statistically significant differences(P<0.05).The diagnostic specificity and positive predictive value for simple appendicitis and periappendiceal abscess were both 100%.Conclusion The convex array combined with linear array probe ultrasound technology has good overall efficacy in the classification and differential diagnosis of acute appendicitis,especially in the diagnosis of simple appendicitis and periappendiceal abscess.
作者
李伟
Li Wei(Department of Ultrasound,Zhengzhou Traditional Chinese Medicine Hospital,Zhengzhou 450007,China)
出处
《实用医技杂志》
2025年第12期922-925,共4页
Journal of Practical Medical Techniques
关键词
阑尾炎
超声检查
诊断
鉴别
Appendicitis
Ultrasonography
Diagnosis,differential
