Sun Zusong,Duan Xufei,Yan Xueqiang.Risk factors and predictive values of ovarian torsion necrosis in children[J].Journal of Clinical Pediatric Surgery,,():46-50.[doi:10.3760/cma.j.cn101785-202311024-009]
Risk factors and predictive values of ovarian torsion necrosis in children
- Keywords:
- Ovarian Torsion; Ovarian Necrosis; Surgical Procedures; Operative; Child
- 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 operation in Wuhan Children’s Hospital,Tongji Medical College,Huazhong University of Science & Technologyfrom May 2014 to May 2014,and to 2023.According to the results of pathological examination,they were assigned 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 masses 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],lymphocyte[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)×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 parameters,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.
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Memo
收稿日期:2023-11-16。
基金项目:儿童肝胆胰疾病研究室基金(2022FEYJS004)
通讯作者:段栩飞,Email:alendxf6@hotmail.com