John H, Neff U, Kelemen M
Chirurgische Abteilung, Kreisspital Bülach.
Helv Chir Acta. 1991 Feb;57(5):671-7.
The aim of the presented study was to find whether improvement has ultrasonography in the diagnosis of acute appendicitis and on surgeon's decision referring to laparotomy. 111 patients entering into the emergency station with suspected appendicitis were evaluated in a prospective clinical study. Surgeon and radiologist had to commit themselves to the diagnosis, afterwards signs were discussed. In 32% the appendix was well seen (accuracy 80%), in 27% sonographic examination was doubtful (accuracy 70%) and in 41% the appendix could not be demonstrated. Diameter of normal appendix was 8 mm compared to inflamed appendix with 12 mm (p less than 0.05). The negative laparotomy decreased from 16% to 12.7%. Surgeon was not influenced by sonography in 75%. In 12% ultrasonography decided for laparotomy and in 4.5% sonography prevented operation. We conclude from our results, that sonography reduces negative laparotomy rate. Especially ultrasonography is useful in doubtful clinical pictures.
本研究的目的是探究超声检查在急性阑尾炎诊断中的改进情况以及对外科医生决定进行剖腹手术的影响。在一项前瞻性临床研究中,对111名因疑似阑尾炎进入急诊室的患者进行了评估。外科医生和放射科医生必须确定诊断结果,之后对体征进行讨论。32%的病例中阑尾显示清晰(准确率80%),27%的超声检查结果存疑(准确率70%),41%的病例中阑尾无法显示。正常阑尾直径为8毫米,发炎阑尾直径为12毫米(p<0.05)。阴性剖腹手术率从16%降至12.7%。75%的情况下外科医生不受超声检查结果的影响。12%的病例中超声检查决定进行剖腹手术,4.5%的病例中超声检查避免了手术。我们从研究结果得出结论,超声检查可降低阴性剖腹手术率。特别是在临床情况存疑时,超声检查很有用。