Prasannan Subhita, Zhueng Tam Jenn, Gul Yunus A
Department of Surgery, Faculty of Medicine and Health Sciences, University Putra Malaysia, Selangor, Malaysia.
Asian J Surg. 2005 Oct;28(4):246-51. doi: 10.1016/S1015-9584(09)60354-7.
A prospective study was performed over a 3-month period in a tertiary referral centre to evaluate the appropriateness and contribution of plain abdominal radiographs (PAR) in the diagnosis and management of adult patients presenting with acute abdominal pain.
Forward stepwise logistic regression was used to examine the correlation between PAR findings and the final diagnosis. The Chi-squared test was used to determine any changes in patient management including requirement for surgical intervention based on PAR findings (p < 0.05).
Of 168 patients (246 PAR), 59 (35%) had positive findings on PAR. PAR were most sensitive in cases of intestinal obstruction (odds ratio, OR = 33.548, r = 0.561). The sensitivity was further increased if three of the following predictive signs were present: exaggerated bowel sounds (OR = 13.350, r = 0.154), abdominal distension (OR = 2.993, r = 0.234) and age over 50 years (OR = 2.301, r = 0.027). PAR were non-diagnostic in 82% of patients with acute abdominal pain (p < 0.001).
PAR do not play a major role in influencing the management of patients with acute abdominal pain without coexisting bowel obstruction.
在一家三级转诊中心进行了为期3个月的前瞻性研究，以评估腹部平片（PAR）在诊断和管理成年急性腹痛患者中的适用性和作用。
采用向前逐步逻辑回归分析来检验PAR检查结果与最终诊断之间的相关性。使用卡方检验来确定患者管理方面的任何变化，包括基于PAR检查结果的手术干预需求（p < 0.05）。
168例患者（共246次PAR检查）中，59例（35%）PAR检查结果为阳性。PAR在肠梗阻病例中最敏感（优势比，OR = 33.548，r = 0.561）。如果出现以下三种预测体征中的三种，敏感性会进一步提高：肠鸣音亢进（OR = 13.350，r = 0.154）、腹胀（OR = 2.993，r = 0.234）和年龄超过50岁（OR = 2.301，r = 0.027）。82%的急性腹痛患者PAR检查无诊断价值（p < 0.001）。
在没有并存肠梗阻的急性腹痛患者管理中，PAR未发挥主要作用。
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