North Tees and Hartlepool NHST Trust, Hardwck Road, Stockton on Tees, UK.
Int J Surg. 2011;9(2):169-72. doi: 10.1016/j.ijsu.2010.10.014. Epub 2010 Nov 5.
The aim of this study is to examine the role of ultrasound in conjunction with clinical judgment in diagnosing occult inguinal hernias in patients with groin pain.
The study involved a retrospective analysis of 297 patients who presented over an 18 month period from January 2007 to August 2008. All the patients presented to outpatient clinic with groin pain but a normal or equivocal clinical examination. Data was obtained from hospital records, radiology system and operation notes.
167 examinations (56%) were positive for a hernia, as a result of which 116 patients underwent surgery. At surgery, a hernia was found in 85 cases and no hernia was found in 31 cases. 130 examinations (44%) were negative for hernia. Six patients proceeded to surgery despite a negative ultrasound due to ongoing pain and a hernia was found in 5 cases. Overall, correlation with surgical findings showed ultrasound to have a sensitivity of 94%. Ultrasound used with clinical judgment has a positive predictive value of 73%.
Ultrasound scan alone in diagnosing groin hernias is not effective when correlated with operative findings. However in conjunction with clinical judgment it is a useful tool in diagnosing occult inguinal groin hernias and aiding in further management.
本研究旨在探讨超声检查结合临床判断在诊断腹股沟区疼痛患者隐匿性腹股沟疝中的作用。
本研究回顾性分析了 2007 年 1 月至 2008 年 8 月期间的 297 例患者。所有患者均因腹股沟区疼痛就诊于门诊，但临床检查正常或不确定。数据来自医院记录、放射学系统和手术记录。
167 次检查（56%）提示疝阳性，其中 116 例患者接受了手术。手术中发现疝 85 例，无疝 31 例。130 次检查（44%）提示无疝。6 例患者尽管超声检查为阴性，但因持续疼痛而行手术，其中 5 例发现疝。总体而言，与手术结果的相关性显示超声检查的敏感性为 94%。超声检查结合临床判断的阳性预测值为 73%。
与手术结果相关时，超声单独诊断腹股沟疝并不有效。然而，结合临床判断，它是诊断隐匿性腹股沟疝的有用工具，并有助于进一步的管理。
