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使用儿科尾炎评分 (PAS) 改善儿童尾炎预测:三年后期研究

Mhd Anas Murad¹, Mohamed Elgaml², Mohamad Wahib Zhlawi³

¹General and Colorectal Surgery, Southend University Hospital, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, GBR.

|August 28, 2025

概括

在日常护理中实施儿科尾炎评分 (PAS) 改善了儿童尾炎的风险分层. 虽然不具有统计意义,但阴性尾切除率下降,显示出更好的诊断准确度的潜力.

科学领域:

儿童手术
紧急医疗
诊断的准确性

背景情况:

急性尾炎是一种常见的儿科手术紧急情况,
儿科尾炎评分 (PAS) 有助于风险分层,但实际应用情况有所不同.
标准化诊断对于减少尾切除率至关重要.

研究的目的:

评估儿童尾炎评分 (PAS) 在常规临床实践中的影响.
评估教育干预对阴性尾切除率和诊断准确性的影响.
分析地区总医院PAS的诊断性能.

主要方法:

一项对190名接受尾切除的儿科患者进行的两轮回顾性审计.
介绍基于GIRFT腹痛路径的教育干预和快速参考指南.
通过敏感度,特异性,预测值和AUC-ROC来评估PAS诊断性能.

主要成果:

在干预后,阴性尾切除率从29. 5%降至17. 6% (不具有统计学意义).
PAS ≥7显示87%的特异性和40%的敏感性; PAS ≥4显示96%的敏感性和31%的特异性.
在确诊的尾炎病例中,平均PAS显著高 (6. 18 vs 4. 69; p < 0. 001), AUC- ROC为0. 73.

结论:

常规PAS实施改善了风险分层,并趋向于减少负尾切除.
高PAS分数 (≥7) 是特定的,低分数 (≤3) 有效排除疾病,中等分数受益于附加物.
建议进行更多的多中心成像研究,以提高诊断准确度和减少阴性尾切除术.

关键词:

急性尾炎尾炎得分诊断情况阴性尾切除术儿童药物

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