Golea Adela, Badea Radu, Suteu Titus
Emergency Medicine Department, University of Medicine and Pharmacy "Iuliu Hatieganu", 1-3 Clinicilor Street Cluj Napoca, Code 400006, Romania.
Med Ultrason. 2010 Dec;12(4):271-9.
THE AIM of this study was to analyse the performance of ultrasonography in the diagnosis of gallbladder conditions requiring surgical intervention.
We performed an observational retrospective study for the assessment of ultrasound in patients having symptomatic gallbladder lithiasis.
The study group included 179 patients with a mean age of 59.31 +/- 15.82 years. The Kruskal Wallis test showed statistically significant differences (KW, p=0.00003) between the mean thickness of the gallbladder wall found in the 4 morphological types of cholecystitis. The statistical significance analysis using "Risk Ratio"(RR) and "Odd test"(OR) showed an increased risk in patients having documented gallbladder lithiasis to develop catarrhal cholecystitis (RR=1.19; OR=1.32, 95% CI 0.71-2.44). For the diagnosis of gallbladder lithiasis during acute cholecystitis, we found a 100% sensitivity, 98.7% specificity, with a 98.7% PPV, 100% NPV and a 93.39% method accuracy. For the diagnosis of various types of acute cholecystitis, we found a 89.99% sensitivity, 84.44% specificity, 88.31% PPV, 86.09% NPV, with a 87.35% method accuracy.
Ultrasonography is a method of high accuracy in the diagnosis of gallbladder lithiasis (93.39%) and its complication--acute cholecystitis (87.35%). The risk analysis for the occurrence of gallbladder complications and the increased risk for developing a severe form of acute cholecystitis in patients without documented lithiasis proves the essential contribution of ultrasonography in optimizing emergency surgical decision and therapy.
本研究的目的是分析超声检查在诊断需要手术干预的胆囊疾病中的表现。
我们进行了一项观察性回顾性研究，以评估有症状胆囊结石患者的超声检查情况。
研究组包括179例患者，平均年龄为59.31±15.82岁。Kruskal Wallis检验显示，在4种形态学类型的胆囊炎中发现的胆囊壁平均厚度之间存在统计学显著差异（KW，p = 0.00003）。使用“风险比”（RR）和“优势检验”（OR）进行的统计学显著性分析显示，有记录的胆囊结石患者发生卡他性胆囊炎的风险增加（RR = 1.19；OR = 1.32，95%CI 0.71 - 2.44）。对于急性胆囊炎期间胆囊结石的诊断，我们发现敏感性为100%，特异性为98.7%，阳性预测值为98.7%，阴性预测值为100%，方法准确性为93.39%。对于各种类型急性胆囊炎的诊断，我们发现敏感性为89.99%，特异性为84.44%，阳性预测值为88.31%，阴性预测值为86.09%，方法准确性为87.35%。
超声检查是诊断胆囊结石（93.39%）及其并发症——急性胆囊炎（87.35%）的一种高精度方法。胆囊并发症发生的风险分析以及无记录结石患者发生严重形式急性胆囊炎的风险增加，证明了超声检查在优化急诊手术决策和治疗方面的重要贡献。
