术前纤维蛋白原联合RIPASA评分对急性阑尾炎严重程度的诊断价值研究

发布时间：2018-05-07 03:33

本文选题：纤维蛋白原 + RIPASA评分　；参考：《西安医学院》2017年硕士论文

【摘要】：目的探讨术前纤维蛋白原联合RIPASA评分对急性阑尾炎严重程度的诊断价值。方法回顾性分析2014年12月至2016年9月在西安高新医院普外科行腹腔镜或开腹阑尾切除术并术后病理证实为急性阑尾炎患者256例。按病理结果分为急性单纯性阑尾炎组32例,急性化脓性阑尾炎组176例,急性坏疽/穿孔性阑尾炎组48例,均采用全自动血凝仪检测术前纤维蛋白原水平,同时评估术前RIPASA评分。结果受试者工作曲线分析结果示,术前纤维蛋白原联合RIPASA评分诊断坏疽/穿孔性AA的线下面积、敏感性、特异性分别为0.817(P0.0001)、75.00%(95%CI 60.4~86.4)、78.00%(95%CI 72.7~84.2);术前纤维蛋白原联合RIPASA评分诊断急性复杂性阑尾炎(包括急性化脓性阑尾炎组、急性坏疽/穿孔性阑尾炎组)的线下面积、敏感性、特异性为0.944(P0.0001)、81.25%(95%CI 75.5~86.1)、100%(95%CI 89.1~100.0)。结论术前纤维蛋白原联合RIPASA评分对急性复杂性阑尾炎有着较高的诊断价值,对急性坏疽/穿孔性阑尾炎有一定的诊断价值,因此有助于术前评估急性阑尾炎的严重程度。
[Abstract]:Objective to evaluate the diagnostic value of preoperative fibrinogen and RIPASA score in acute appendicitis. Methods from December 2014 to September 2016, 256 patients with acute appendicitis were treated by laparoscopy or open appendectomy in general surgery department of Xi'an High Tech Hospital from December 2014 to September 2016. According to the pathological results, 32 cases of acute simple appendicitis group, 176 cases of acute suppurative appendicitis group and 48 cases of acute gangrene / perforated appendicitis group were divided into three groups. The preoperative fibrinogen level was detected by automatic hemagglutination apparatus and the preoperative RIPASA score was evaluated. Results the results of operating curve analysis showed that preoperative fibrinogen combined with RIPASA score was used to diagnose sublinear area and sensitivity of gangrene / perforated AA. The specificity was 0.817 P0.0001 / 95 CI 60.4 / 86.4and 78.00 / 95 CI 72.7 / 84.2 respectively. The area and sensitivity of preoperative fibrinogen combined with RIPASA score in the diagnosis of acute complicated appendicitis (including acute suppurative appendicitis, acute gangrene / perforated appendicitis) were 0.944 P0.0001 / 81.2595CI75.56.1and 100 95 CI 89.1100.0. Conclusion preoperative fibrinogen combined with RIPASA score has high diagnostic value for acute complicated appendicitis and has certain diagnostic value for acute gangrene / perforated appendicitis, so it is helpful to evaluate the severity of acute appendicitis before operation.
【学位授予单位】：西安医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R656.8

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