本文選題：纖維蛋白原 + RIPASA評分�。� 參考：《西安醫(yī)學院》2017年碩士論文

【摘要】：目的探討術(shù)前纖維蛋白原聯(lián)合RIPASA評分對急性闌尾炎嚴重程度的診斷價值。方法回顧性分析2014年12月至2016年9月在西安高新醫(yī)院普外科行腹腔鏡或開腹闌尾切除術(shù)并術(shù)后病理證實為急性闌尾炎患者256例。按病理結(jié)果分為急性單純性闌尾炎組32例,急性化膿性闌尾炎組176例,急性壞疽/穿孔性闌尾炎組48例,均采用全自動血凝儀檢測術(shù)前纖維蛋白原水平,同時評估術(shù)前RIPASA評分。結(jié)果受試者工作曲線分析結(jié)果示,術(shù)前纖維蛋白原聯(lián)合RIPASA評分診斷壞疽/穿孔性AA的線下面積、敏感性、特異性分別為0.817(P0.0001)、75.00%(95%CI 60.4~86.4)、78.00%(95%CI 72.7~84.2);術(shù)前纖維蛋白原聯(lián)合RIPASA評分診斷急性復(fù)雜性闌尾炎(包括急性化膿性闌尾炎組、急性壞疽/穿孔性闌尾炎組)的線下面積、敏感性、特異性為0.944(P0.0001)、81.25%(95%CI 75.5~86.1)、100%(95%CI 89.1~100.0)。結(jié)論術(shù)前纖維蛋白原聯(lián)合RIPASA評分對急性復(fù)雜性闌尾炎有著較高的診斷價值,對急性壞疽/穿孔性闌尾炎有一定的診斷價值,因此有助于術(shù)前評估急性闌尾炎的嚴重程度。
[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.
【學位授予單位】：西安醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R656.8

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