对儿童急性尾炎的经典症状"吐前的腹痛"进行诊断
Hiroki Kitaoka1, Hayato Chikai2, Keiko Watanabe1
1Department of Pediatrics, Yaizu City Hospital, Shizuoka, Japan; Department of Pediatrics, University of Tokyo Hospital, Tokyo, Japan.
Pediatrics and neonatology
|July 24, 2023
概括
在腹痛之前吐并不可靠地排除儿童尾炎. 经过验证的评分系统,如阿尔瓦拉多评分,对于诊断儿科尾炎来说是优越的.
科学领域:
- 儿科手术 儿科手术
- 诊断的准确性 诊断的准确性
- 腹部疼痛管理 腹部疼痛管理
背景情况:
- 急性尾炎是儿童常见的手术紧急情况.
- 教科书建议在疼痛排除尾炎之前吐,但这缺乏儿科验证.
研究的目的:
- 为了评估儿童尾炎的"吐前的腹痛"的诊断性能.
- 为了将这种症状模式与已建立的评分系统进行比较.
主要方法:
- 对134名患有腹痛和吐的儿童进行了回顾性观察研究.
- 计算机断层扫描 (CT) 扫描作为尾炎的参考标准.
- "吐前的腹痛"与阿尔瓦拉多和儿科尾炎得分的比较.
主要成果:
- "吐前的腹痛"具有较低的特异性 (25.0%) 和较差的诊断几率比率 (1.02).
- 阿尔瓦拉多和儿科尾炎得分显示出高灵敏度 (98.3%) 和强大的诊断能力.
- 验证的得分在诊断儿科尾炎时显著超过了症状模式.
结论:
- "吐前的腹痛"的症状对于排除儿童急性尾炎的诊断价值很低.
- 儿科尾炎的诊断应依赖于经过验证的评分系统,如阿尔瓦拉多和儿科尾炎评分.
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