Harswick Chad, Uyenishi Amy Archer, Kordick Mary Frances, Chan Shu B
Resurrection Emergency Medicine Residency Program, Resurrection Medical Center, Chicago, IL 60631, USA.
Am J Emerg Med. 2006 Jan;24(1):68-72. doi: 10.1016/j.ajem.2005.07.015.
Prior studies suggest that preoperative abdominal computed tomography (CT) scan can contribute to a low negative appendectomy rate. Our study objective was to evaluate cases of negative appendectomies for clinical criteria and CT use.
Retrospective 1-year study of all negative appendectomies at a community hospital. Data included clinical evidence for appendicitis as well as CT results if performed.
Of 122 cases reviewed, 8 (6.6%) were negative appendectomies. Six were younger than 20 years. Four had a preoperative CT scan. Overall, 106 (87%) of 122 cases received preoperative CT and had a negative appendectomy rate of 3.8%. Sixteen cases did not have preoperative CT and had a negative appendectomy rate of 25% (odds ratio, 8.5; 95% confidence interval, 1.9-38.5; Fisher exact test P = .01).
Patients who had a CT scan for suspected appendicitis had a lower rate of negative appendectomies than those who had no CT. Most of the negative appendectomies occurred in patients younger than 20 years.
先前的研究表明，术前腹部计算机断层扫描（CT）有助于降低阴性阑尾切除术的发生率。我们的研究目的是评估阴性阑尾切除术的病例，以了解其临床标准和CT的使用情况。
对一家社区医院所有阴性阑尾切除术进行为期1年的回顾性研究。数据包括阑尾炎的临床证据以及（若进行了CT检查）CT结果。
在122例回顾病例中，8例（6.6%）为阴性阑尾切除术。6例年龄小于20岁。4例进行了术前CT扫描。总体而言，122例中有106例（87%）接受了术前CT检查，阴性阑尾切除术发生率为3.8%。16例未进行术前CT检查，阴性阑尾切除术发生率为25%（优势比为8.5；95%置信区间为1.9 - 38.5；Fisher精确检验P = 0.01）。
因疑似阑尾炎而进行CT扫描的患者，其阴性阑尾切除术的发生率低于未进行CT扫描的患者。大多数阴性阑尾切除术发生在年龄小于20岁的患者中。
