减少不必要的阑尾切除术：超声检查和计算机断层扫描在急性阑尾炎中的评估
Reducing negative appendectomy: evaluation of ultrasonography and computer tomography in acute appendicitis.
作者信息
Styrud J, Josephson T, Eriksson S
机构信息
Department of Surgery, Karolinska Institutet at Danderyd Hospital, Sweden.
出版信息
Int J Qual Health Care. 2000 Feb;12(1):65-8. doi: 10.1093/intqhc/12.1.65.
OBJECTIVE
To study the sensitivity and the specificity for ultrasonography and computed tomography in patients with suspected appendicitis, and their value to the clinician.
MAIN OUTCOME MEASURES
The negative appendectomy rate and the sensitivity and the specificity for ultrasonography and computed tomography in patients with suspected appendicitis.
RESULT
The diagnostic accuracy was 88% (men 95%, women 80%). Two hundred and thirty-nine patients were examined by ultrasonography preoperatively. The sensitivity for ultrasonography was 0.82 and the specificity was 0.97. Forty-nine patients were examined by computed tomography preoperatively. The sensitivity for computer tomography was 0.88 and the specificity was 0.95.
CONCLUSIONS
We conclude that ultrasound and computed tomography investigations on patients with suspected appendicitis are of great value. Computed tomography seems to have a higher sensitivity than ultrasound and a high specificity. In fertile women, where unnecessary surgery is best avoided, we believe that computed tomography investigation or ultrasound examination are better alternatives to surgical intervention.
目的
研究超声检查和计算机断层扫描对疑似阑尾炎患者的敏感性和特异性，以及它们对临床医生的价值。
主要观察指标
疑似阑尾炎患者的阴性阑尾切除率以及超声检查和计算机断层扫描的敏感性和特异性。
结果
诊断准确率为88%（男性95%，女性80%）。术前对239例患者进行了超声检查。超声检查的敏感性为0.82，特异性为0.97。术前对49例患者进行了计算机断层扫描。计算机断层扫描的敏感性为0.88，特异性为0.95。
结论
我们得出结论，对疑似阑尾炎患者进行超声和计算机断层扫描检查具有重要价值。计算机断层扫描似乎比超声具有更高的敏感性和较高的特异性。在育龄女性中，最好避免不必要的手术，我们认为计算机断层扫描检查或超声检查是手术干预的更好替代方法。
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