Rüttimann S, Clémençon D, Dubach U C
Medizinische Universitäts-Poliklinik, Departement für Innere Medizin, Kantonsspital Basel.
Schweiz Med Wochenschr. 1992 Dec 26;122(51-52):1952-4.
When abdominal ultrasound is performed it is general practice to examine not only the organs needed to answer the clinician's question but also the remaining abdominal and pelvic organs for which there is no clinical indication (= routine examinations). We investigated the effect of these routine examinations on the further management in 533 medical outpatients (222 women; 311 men; age 45 +/- 16 years). Of 7684 organs examined, 6194 (81%) were routine examinations, 469 of which revealed unexpected abnormalities. Only 19 of these were considered clinically relevant enough to warrant further work-up, and long-term follow-up was regarded as necessary in 6 patients only. However, an abnormal finding on routine examination had no eventual therapeutic implications in any patient. We conclude that in middle-aged medical outpatients it is sufficient to perform sonography on those abdominal and pelvic organs which need to be examined to answer the clinician's questions. Failure to routinely examine the remaining organs does not lead to a relevant loss of information, but may save time and money on fruitless work-up of unexpected findings.
在进行腹部超声检查时，通常的做法是不仅要检查回答临床医生问题所需的器官，还要检查没有临床指征的其余腹部和盆腔器官（即常规检查）。我们调查了这些常规检查对533名内科门诊患者（222名女性；311名男性；年龄45±16岁）进一步治疗的影响。在检查的7684个器官中，6194个（81%）是常规检查，其中469个发现了意外异常。其中只有19个被认为具有足够的临床相关性，需要进一步检查，只有6名患者被认为有必要进行长期随访。然而，常规检查中的异常发现最终对任何患者都没有治疗意义。我们得出结论，对于中年内科门诊患者，对那些为回答临床医生问题而需要检查的腹部和盆腔器官进行超声检查就足够了。不常规检查其余器官不会导致相关信息的丢失，但可能会节省对意外发现进行徒劳检查的时间和金钱。
