Takayuki Fujii, Aya Tanaka, Hiroto Katami, Ryuichi Shimono
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引用次数: 0
摘要
目的:评价腹部平片表现与临床症状相结合对儿童肠套叠初步筛查的应用价值。结果:152例患儿中有90例诊断为肠套叠。呕吐(优势比[OR], 8.1;95%可信区间[CI] 2.1-32.2),间歇性疼痛(OR 9.8;95% CI 2.3-41.4),腹部x线片阳性(OR 85.1;95% CI 12.6-575.0)被认为是重要的预测因子。腹部x线摄影显示高灵敏度(97%)和阴性预测值(93%)。相比之下,结合三种预测因子可将诊断特异性和阳性预测值分别提高至95%和91%。综合预测指标的曲线下面积为0.92,表现出良好的诊断效果。结论:将腹部x线表现与临床症状相结合可提高肠套叠的诊断准确性,为初步筛查提供了一种实用的方法。
Simplified predictive model for intussusception in children: combining radiographic and clinical features.
Purpose: To evaluate the utility of combining plain abdominal radiography findings with clinical symptoms for the primary screening of intussusception in children.
Methods: A total of 152 children aged < 16 years, who were admitted with suspected intussusception between April, 2008 and October, 2024, were enrolled in this retrospective cohort study. We analyzed the demographic data, clinical symptoms, laboratory findings, and abdominal radiography results of all participants. Logistic regression and receiver operating characteristic curves were used to identify significant predictors and assess the diagnostic performance, respectively.
Results: Intussusception was diagnosed in 90 of the 152 patients. Vomiting (odds ratio [OR], 8.1; 95% confidence interval [CI] 2.1-32.2), intermittent pain (OR 9.8; 95% CI 2.3-41.4), and abdominal radiography positivity (OR 85.1; 95% CI 12.6-575.0) were identified as significant predictors. Abdominal radiography demonstrated a high sensitivity (97%) and negative predictive value (93%). In contrast, combining the three predictors improved the diagnostic specificity and positive predictive value to 95% and 91%, respectively. The combined predictors achieved an area under the curve of 0.92, indicating excellent diagnostic performance.
Conclusions: Combining abdominal radiography findings with clinical symptoms enhances the diagnostic accuracy of intussusception and provides a practical approach for primary screening.
期刊介绍:
Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it").
The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.