[The value of ultrasound diagnosis in "acute appendicitis" patient admission].

S Sidler, D Heim, M Negri, U Stricker
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引用次数: 3

Abstract

Unlabelled: The rate of unnecessary appendectomy is frequently criticized. Today, sonography and CT-scan are helpful tools to minimize this rate. Which value has the ultrasonography in the decision making today?

Methods: Retrospective analysis of 132 patients undergoing appendectomy in respect of sonography and rate of histologically confirmed appendicitis from 1.1.95-31.12.98. Prospective analysis of 99 patients admitted for acute appendicitis in respect of pre- and posttest-probability (after sonography) by the responsible surgeon from 1.1.99-31.12.00.

Results: Retrospective part: 122/132 patients had an acute appendicitis (92%). Sonography was performed in 64% of the patients. There was only one wrongly positive sonography. Prospective part: 76/99 patients were operated on. 70/76 had an acute appendicitis (92%). Sonography was performed in 87%. Six patients presented a histologically normal appendix: In two of them no increase of the probability after sonography was noted, in three of them an slight increase of only 20%, and in one of them a decrease of 20% even.

Conclusion: Sonography with a pre- and posttest-probability is recommended in clinically doubtful cases. In our experience the physician performing the sonography is almost always right. But the diagnosis of an acute appendicitis remains a combination of clinical and sonographic evaluation.

[超声诊断在“急性阑尾炎”患者入院中的价值]。
未标注:不必要的阑尾切除术率经常受到批评。如今,超声检查和ct扫描是将这一比率降至最低的有用工具。超声检查在今天的决策中有哪些价值?方法:回顾性分析1995年1月1日~ 1998年12月31日行阑尾切除术的132例患者的超声检查及组织学证实的阑尾炎发生率。对1999年1月1日至12月31日期间99例急性阑尾炎住院患者的超声检查前后概率(超声检查后)进行前瞻性分析。结果:回顾性分析:132例患者中有122例发生急性阑尾炎(92%)。64%的患者行超声检查。超声检查只有一个错误阳性。前瞻性部分:76/99例患者接受手术治疗。70/76(92%)有急性阑尾炎。超声检查占87%。6例患者表现为组织学上正常的阑尾:其中2例超声检查后阑尾病变概率未增加,3例仅轻微增加20%,1例甚至下降20%。结论:对临床有疑点的病例,建议采用超声检查前后概率。根据我们的经验,医生做超声检查几乎总是正确的。但急性阑尾炎的诊断仍然是临床和超声评估的结合。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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