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目的探讨血清纤维蛋白原(fibrinogen,FIB)、体温及扭转度数对于预测扭转附件坏死的临床适用性。方法回顾性分析2013年1月至2016年5月98例手术治疗的附件扭转患者的临床资料,以术后病检结果为金标准,将其分为坏死组(45例),非坏死组(53例),对两组患者的临床资料进行统计学分析。结果坏死组体温、FIB及附件扭转度数均高于非坏死组(P<0.05)。FIB、体温及扭转度数与扭转附件坏死的Spearman相关系数分别为0.246、0.290和0.306;P值分别是0.014、0.004和0.002。体温、FIB及扭转度数对扭转附件坏死预测的ROC曲线的AUC分别为0.668、0.643和0.670;P值分别是0.00 4、0.015和0.004。三者联合对于扭转附件坏死预测的AUC为0.754(P=0.000)。结论坏死组体温、FIB及附件扭转度数均高于非坏死组。体温、FIB及扭转度数对于扭转附件坏死均具有一定的预测性,但预测价值相对较低;三个指标联合的预测价值优于单指标的预测价值。
Objective To investigate the clinical applicability of serum fibrinogen (FIB), body temperature and degree of torsion in predicting the necrosis of torsion attachment. Methods A retrospective analysis of 98 cases of surgical treatment of patients with surgical repair of the clinical data of patients with postoperative pathological examination as the gold standard, divided into necrosis group (45 cases), non-necrosis group 53 cases), the clinical data of two groups were statistically analyzed. Results The body temperature, the FIB and the degree of attachment twisting in the necrosis group were higher than those in the non-necrosis group (P <0.05). Spearman correlation coefficients of FIB, body temperature, degree of torsion and necrosis of torsion attachment were 0.246, 0.290 and 0.306 respectively; P values were 0.014, 0.004 and 0.002, respectively. The AUC of body temperature, FIB and degree of torsion for predicting necrosis of torsion attachment were 0.668, 0.643 and 0.670, respectively; P values were 0.00 4,0.015 and 0.004, respectively. The AUC of the three combinations for predicting necrosis of attachment was 0.754 (P = 0.000). Conclusion The body temperature, FIB and attachment torsion in necrosis group were higher than those in non-necrosis group. Body temperature, FIB and degree of torsion are both predictive of the necrosis of the appendix, but their predictive value is relatively low. The predictive value of the combination of the three indicators is superior to the predictive value of the single index.