我们是否在非创伤性急性腹痛中过度使用超声？
Are we overusing ultrasound in non-traumatic acute abdominal pain?
作者信息
Raman S, Somasekar K, Winter R K, Lewis M H
机构信息
Department of Surgery, Royal Glamorgan Hospital, Llantrisant, Mid Glamorgan CF72 8XR, Wales, UK.
出版信息
Postgrad Med J. 2004 Mar;80(941):177-9. doi: 10.1136/pgmj.2003.013805.
BACKGROUND
Ultrasound is being used increasingly in the assessment of acute non-traumatic abdominal pain as it is non-invasive and does not carry the risk of radiation. However, the inappropriate use of ultrasound can lead to a delayed or incorrect diagnosis, more work for the personnel involved, and increased hospital costs.
METHODS
A prospective study was conducted to analyse the clinical indications for requesting an ultrasound in those admitted to a district general hospital with acute non-traumatic abdominal pain, and to assess whether there is a correlation between clinical and laboratory findings and ultrasound results. A total of 110 patients were studied during a three month period.
RESULTS
The results suggest that ultrasound is useful in the investigation of suspected biliary colic and abdominal masses. However, the yield of ultrasound in other patients with acute non-traumatic abdominal pain is low. This study also suggests that the yield of "positive" reports on ultrasound is significantly higher in patients with localised abdominal pain and tenderness and in those with acute abdominal pain and a raised white cell count or raised liver function tests. The yield of positive reports in patients with acute abdominal pain was found to be lower those less than 25 years of age than in older patients.
背景
超声因其无创且无辐射风险，在急性非创伤性腹痛评估中的应用日益广泛。然而，超声的不当使用可能导致诊断延迟或错误，增加相关人员的工作量，并提高医院成本。
方法
开展一项前瞻性研究，分析某地区综合医院收治的急性非创伤性腹痛患者申请超声检查的临床指征，并评估临床及实验室检查结果与超声检查结果之间是否存在相关性。在三个月期间共对110例患者进行了研究。
结果
结果表明，超声对疑似胆绞痛和腹部肿块的检查有用。然而，超声在其他急性非创伤性腹痛患者中的检出率较低。本研究还表明，局限性腹痛和压痛患者以及急性腹痛且白细胞计数升高或肝功能检查异常的患者，超声“阳性”报告的检出率显著更高。发现急性腹痛患者中，年龄小于25岁者的阳性报告检出率低于老年患者。
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