临床小儿外科杂志2024，Vol.23Issue(1)：46-50,5.DOI:10.3760/cma.j.cn101785-202311024-009
小儿卵巢扭转坏死的危险因素及其预测价值分析
Risk factors and predictive values of ovarian torsion necrosis in children
摘要
Abstract
Objective To explore the risk factors and predictive values of ovarian torsion(OT)necrosis in children.Methods To summarize the clinical data of 73 children with ovarian torsion diagnosed during op-eration in Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science & Technology-from May 2014 to May 2014,and to 2023.According to the results of pathological examination,they were as-signed into two groups of torsion necrosis(n=27)and non-necrosis(n=46).The age,affected side,malignant behavior and vomiting,fever,time from abdominal pain to operation,platelet,lymphocyte,neutrophil,percentage of Neutrophil,C-reaction protein(CRP),white blood cell(WBC),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),lymphocyte-to-C-reaction protein(LCR)and the diameter of adnexal mas-ses were compared between the two groups.Univariate Logistic regression was used to analyze the risk factors of ovarian torsion necrosis in children.Multivariate Logistic regression was used to analyze the independent risk factors,receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of each index for torsion necrosis of ovary in children.Results No significant inter-group differences existed in age[(7.21 ±3.65)year vs.(8.80±4.17)year],The affected side(left/right){[9(34.62％)/17(65.38％)]vs.[21(44.68％)/26(55.32％)]},platelet[(289.18±94.57)× 109/L vs.(300.06±79.05)× 109/L],lympho-cyte[1.93(1.36,2.74)× 109/L vs.1.60(1.00,2.46)× 109/L],neutrophil[(72.25±14.23)％vs.(69.30±18.69)％],neutrophil-to-lymphocyte ratio(NLR)[6.18(3.68,8.79)vs.5.02(2.38,8.49)],platelet-to-lymphocyte ratio(PLR)[117.31(101.27,199.98)vs.181.99(104.22,282.81)]or lymphocyte to C-reaction protein(LCR)[0.39(0.05,1.45)vs.0.10(0.02,1.73)],the diameter of adnexal masses[5.00(3.97,6.33)cm vs.4.67(3.38,6.17)cm](P＞0.05).Significant inter-group differences existed in degree of OT[720.00(720.00,855.00)° vs.720.00(360.00,720.00)°],nausea and vomiting[21(80.77％)vs.27(57.45％)],fever[9(34.62％)vs.2(4.26％)],time from abdominal pain to operation[72.00(31.50,96.00)h vs.24.00(15.84,45.60)h],neutrophil[10.29(6.30,11.61)× 109/L vs.5.98(3.67,9.04)× 109/L],C-reaction protein(CRP)[9.40(0.78,36.70)mg/L vs.0.84(0.78,2.27)mg/L]and white blood cell(WBC)[13.25(7.92,16.89)x 109/L vs.8.28(6.21,11.87)× 109/L](P＜0.05).The results of ROC showed that the time from abdominal pain to operation had the highest predictive value for ovarian torsion necrosis,the best cut-off was 26.7 h,the area under the ROC curve(AUC)was 0.755,the sensitivity and specificity were 84.6％and 66.0％.The second is the degree of ovarian torsion,the best cut-off value was 405° with an AUC of 0.695,the sensitivity and specificity were 88.5％and 42.6％.Finally for fever,the AUC was 0.652,the sensitivity and specificity were 34.6％and 95.7％.Combining those three pa-rameters,the AUC was 0.870 with a sensitivity of 69.2％and a specificity of 93.6％.Conclusions Time from abdominal pain to operation,degree of OT and fever may effectively predict the occurrence of OT necrosis in children.关键词
卵巢扭转/卵巢坏死/外科手术/儿童Key words
Ovarian Torsion/Ovarian Necrosis/Surgical Procedures,Operative/Child引用本文复制引用
孙祖嵩,段栩飞,闫学强..小儿卵巢扭转坏死的危险因素及其预测价值分析[J].临床小儿外科杂志,2024,23(1):46-50,5.基金项目
儿童肝胆胰疾病研究室基金(2022FEYJS004)Foundation of Pediatric Laboratory of Hepatobiliary & Pancreatic Diseases(2022FEYJS004) （2022FEYJS004）
