Safran D B, Pilati D, Folz E, Oller D
University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Am J Emerg Med. 2001 May;19(3):199-203. doi: 10.1053/ajem.2001.21721.
Reports citing excellent sensitivity, specificity, and predictive accuracy of focused appendiceal computed tomography (CT) and showing an overall reduction in resource use and nontherapeutic laparotomies have led to increasing use of that imaging modality. Diagnostic algorithms have begun to incorporate appendiceal CT for patients presenting to the emergency department with right lower quadrant pain. We present a series of 4 cases in which use of appendiceal CT ultimately led to increased cost, resource use, and complexity in patient care. The results of these cases support an argument against unbridled use of appendiceal CT scanning and reinforce the need for clinical evaluation by the operating surgeon before routine performance of appendiceal CT scan.
有报告称，针对性阑尾计算机断层扫描（CT）具有出色的敏感性、特异性和预测准确性，且显示资源使用和非治疗性剖腹手术总体减少，这导致该成像方式的使用越来越多。诊断算法已开始将阑尾CT纳入用于因右下象限疼痛而到急诊科就诊的患者。我们报告了一系列4例病例，其中阑尾CT的使用最终导致成本增加、资源使用增加以及患者护理复杂性增加。这些病例的结果支持反对无节制使用阑尾CT扫描的观点，并强化了在常规进行阑尾CT扫描之前由主刀外科医生进行临床评估的必要性。
