在儿科ED中重复超声波改善了指导成像后尾炎的诊断
Vitaliy Perepelitsa1, Jeffrey Ames2, Rahul Kaila1
1Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States.
Frontiers in pediatrics
|November 13, 2025
概括
儿科急诊室 (ED) 在用超声波 (US) 诊断尾炎时比一般ED更准确. 标准化培训可以提高诊断的一致性,减少对这种常见的儿科手术紧急情况的不必要干预.
科学领域:
- 儿科急救医学 儿科急救医学
- 诊断成像 诊断成像 诊断成像
- 手术紧急情况 手术紧急情况
背景情况:
- 急性尾炎是儿童经常出现的手术紧急情况.
- 超声波 (美国) 是首选的诊断工具,因为它的安全性和成本效益.
- 美国尾炎的诊断准确度可以根据操作员和部门的专业知识而有所不同.
研究的目的:
- 为了比较急性尾炎的超声波 (US) 的诊断准确性,在指导急诊室 (ED) 和专门的儿科ED之间进行比较.
- 评估美国在不同医疗机构的儿科患者诊断尾炎的敏感性和特异性.
主要方法:
- 对18岁以下的儿科患者进行了回顾性分析,这些患者因疑似尾炎而接受了US.
- 我们比较了美国推ED的检查数据和儿科ED的随后成像数据.
- 诊断性表现指标,包括灵敏度和特异性,在两个设置之间计算和比较.
主要成果:
- 在儿科ED进行的超声波显示,对于诊断尾炎 (p=0.018) 的敏感度显著更高 (85.2%),与参考ED相比 (51.9%).
- 儿科ED US导致非可视化尾 (34.4%) 和模两可的发现 (30.5%) 显著减少.
- 已确诊的尾炎患者的白细胞数量和中性粒细胞百分比增加,虚假阳性率低 (6.9%).
结论:
- 在专门的儿科ED中进行超声波成像,与一般的转诊ED相比,对于急性尾炎的诊断准确度更高.
- 精度的差异可能源于操作员的专业知识和儿科环境中的标准化成像协议.
- 改善推ED的培训和资源可以将诊断差异降至最低,并防止不必要的程序.
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