Ozgüç Halil, Cakin Nurşen, Duman Uğur
Department of General Surgery Medicine, Faculty of Uludağ University, Bursa, Turkey.
Ulus Travma Acil Cerrahi Derg. 2008 Apr;14(2):118-24.
The aims of this study were to determine the diagnostic value of elements of the disease history, the clinical findings and basic laboratory examinations in differential diagnosis of the patients with nonspecific abdominal pain and to analyze the long-term survey of these patients.
A prospective observational study was performed at the Department of General Surgery Medicine Faculty of Uludag University between November 2001 to November 2002. Based on the diagnosis reasons for abdominal pain, 610 patients were classified as being of specific abdominal pain (n=501) versus nonspecific abdominal pain (n=109). Patients with nonspecific abdominal pain were invited to a follow-up examination 24 hours later and 4 follow-up interviews were conducted on days 8, 15, 30 and at the end of 1 year. Statistical analyses were performed between findings of two groups.
In logistic regression analysis, presence of a history of similar pain (odds ratio 1.88; p=0.009), nausea (odds ratio 0.46; p=0.001), rigidity (odds ratio 0.24; p=0.024), fever < or = 36.6 degrees C (odds ratio 1.66; p=0.037), leukocyte count < or = 8700 (odds ratio 1.85; p=0.011), age < or = 39 years (odds ratio 1.85; p=0.018), respiratory rate < or = 15 (odds ratio 3.19; p=0.00..) were significantly independent diagnostic factors. There was no malignancy during one-year follow-up period.
The possibility of a specific cause is higher in patients with history of a similar pain, nausea, rigidity, fever >36.6 degrees C, leukocyte count >8700, age >39 years, respiratory rate >15 in admission and persistent pain 24 hours after discharge.
本研究的目的是确定病史、临床检查结果及基础实验室检查项目在非特异性腹痛患者鉴别诊断中的诊断价值,并对这些患者进行长期随访分析。
2001年11月至2002年11月期间,在乌鲁达格大学医学院普通外科进行了一项前瞻性观察研究。根据腹痛的诊断原因,将610例患者分为特异性腹痛组(n = 501)和非特异性腹痛组(n = 109)。非特异性腹痛患者在24小时后接受随访检查,并在第8天、第15天、第30天和1年末进行4次随访访谈。对两组的检查结果进行统计学分析。
在逻辑回归分析中,有类似疼痛病史(比值比1.88;p = 0.009)、恶心(比值比0.46;p = 0.001)、腹肌紧张(比值比0.24;p = 0.024)、体温≤36.6℃(比值比1.66; p = 0.037)、白细胞计数≤8700(比值比1.85;p = 0.011)、年龄≤39岁(比值比1.85;p = 0.018)、呼吸频率≤15(比值比3.19;p = 0.00...)是显著的独立诊断因素。在一年的随访期内未发现恶性肿瘤。
入院时具有类似疼痛病史、恶心、腹肌紧张、体温>36.6℃、白细胞计数>8700、年龄>39岁、呼吸频率>15且出院后24小时仍有持续性疼痛的患者,存在特定病因的可能性更高。