АНАЛИЗ ШКАЛ ALVARADO И PAS В ДИФФЕРЕНЦИАЛЬНОЙ ДИАГНОСТИКЕ ОСТРОГО ЖИВОТА У ДЕТЕЙ

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Детская хирургия. Журнал им. Ю.Ф. Исакова. 2019; 23: 309-313

АНАЛИЗ ШКАЛ ALVARADO И PAS В ДИФФЕРЕНЦИАЛЬНОЙ ДИАГНОСТИКЕ ОСТРОГО ЖИВОТА У ДЕТЕЙ

Вакульчик В. Г.

https://doi.org/10.18821/1560-9510-2019-23-6-309-313

Аннотация

Актуальность. В настоящее время основные цели диагностики острого аппендицита - повышение точности диагностики деструктивных форм; уменьшение количества негативных аппендэктомий и диагностических лапароскопий. Цель - сравнить результаты шкал Alvarado и PAS и установить, какая из них более адекватна в дифференциальной диагностике острых болей в животе у детей. Материал и методы. Проспективное рандомизированное слепое клиническое исследование. Обследовано 326 детей с болями в животе в возрасте 5-17 лет. Результаты. Не обнаружено существенного преимущества какой-либо из анализируемых шкал в дифференциальной диагностике острых болей в животе у детей в возрасте 5-17 лет. Обе шкалы могут быть применены для первичной стратификации пациентов. При заключении «Острый аппендицит маловероятен» уровень не диагностированных случаев ОА не превысит 3%. Выводы. Необходим дальнейший анализ различных шкал диагностики острого аппендицита у детей с целью выбора оптимальной. Полученные результаты диктуют необходимость модификаций шкал для повышения точности диагностики и снижения количества негативных аппендэктомий и диагностических лапароскопий.

Список литературы

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Russian Journal of Pediatric Surgery. 2019; 23: 309-313

THE COMPARATIVE ANALYSIS OF ALVARADO AND PAS SCALES IN THE DIFFERENTIAL DIAGNOSTICS OF ACUTE ABDOMINAL PAIN IN CHILDREN

Vakulchyk V. G.

https://doi.org/10.18821/1560-9510-2019-23-6-309-313

Abstract

Introduction. Current trends in the diagnostics of acute appendicitis have the following main objectives: to improve the diagnostic accuracy in destructive forms; to reduce the number of negative appendectomies and diagnostic laparoscopies. Purpose. To compare the effectiveness of Alvarado and PAS scales and to find out which of them is more appropriate in the differential diagnostics of acute abdominal pain in children. Material and Methods. A prospective randomized blind clinical trial was performed. 326 children aged 5-17 years with abdominal pain were examined. Results. No significant advantages of any of the analyzed scales were found in the differential diagnostics of acute abdominal pain in children aged 5-17 years. Both scales can be used in the primary stratification of patients. With the conclusion “Acute appendicitis is likely possible,” the level of non-diagnosed cases of acute appendicitis will not exceed 3%. Conclusions. Further assessment of various scales for the diagnostics of acute appendicitis in children has to be done in order to select the optimal one. The obtained results urge to make scales’ modification so as to improve the diagnostic accuracy and to reduce the number of negative appendectomies and diagnostic laparoscopies.

References

1. Colson M., Skinner K.A., Dunnington G. High negative appendectomy rates are no longer acceptable. The Amer. Jour. of Surg. 1997; 174 (6). 723-7.

4. Al-Abed Y.A., Alobaid N., Myint F. Diagnostic markers in acute appendicitis. Am J Surg. 2015; 209(6): 1043-7.

5. Acharya A., Markar S.R., Ni M., Hanna G.B. Biomarkers of acute appendicitis: systematic review and cost-benefit trade-off analysis. Surg Endosc. 2017; 31(3): 1022-31.

6. Bakal U., Aydin S., Sarac M., Kuloglu T., Kalayci M., Artas G., et al. Serum, Saliva, and Urine Irisin with and Without Acute Appendicitis and Abdominal Pain. Biochem Insights. 2016; 9: 11-7.

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16. Ilce Z., Yildiz T., Isleyen M. The role of laparoscopy in suspicious abdomen pain in children. Pak J Med Sci. 2013; 29(4): 1042-5.

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24. Dingemann J., Ure B. Imaging and the use of scores for the diagnosis of appendicitis in children. Eur Jour Ped Surg. 2012; 22(3): 195-200.

25. Rentea R.M., Peter S.D.St. Contemporary management of appendicitis in children. Advan in Pediatr. 2017; 64(1): 225-51.

26. Malik A.A., Nizami F.A. Clinical Scoring System for Diagnosis of Acute Appendicitis in Children. Ind Jour Pediatr. 2010; 78(3): 287-90.

27. Pogorelis Z., Rak S., Mrklis I., Juris I. Prospective validation of Alvarado score and Pediatric Appendicitis Score for the diagnosis of acute appendicitis in children. Pediatr Emerg Care. 2015; 31(3): 164-8.

28. Schneider C., Kharbanda A., Bachur R. Evaluating appendicitis scoring systems using a prospective pediatric cohort. Annals Emerg Med. 2007; 49(6): 778-84e1.

АНАЛИЗ ШКАЛ ALVARADO И PAS В ДИФФЕРЕНЦИАЛЬНОЙ ДИАГНОСТИКЕ ОСТРОГО ЖИВОТА У ДЕТЕЙ

Аннотация

THE COMPARATIVE ANALYSIS OF ALVARADO AND PAS SCALES IN THE DIFFERENTIAL DIAGNOSTICS OF ACUTE ABDOMINAL PAIN IN CHILDREN

Abstract

События