Suh Suk Won, Choi Yoo Shin, Park Joong Min, Kim Beom Gyu, Cha Seong Jae, Park Sung Jun, Chang In Taik
Department of Surgery, College of Medicine, Chung-Ang University, Seoul, Korea.
Surg Laparosc Endosc Percutan Tech. 2011 Apr;21(2):72-5. doi: 10.1097/SLE.0b013e31820e762c.
The accurate and early diagnosis of perforated appendicitis (PA) is important when a surgeon is making decisions with regard to time and method of operation that are critical in reducing morbidity and mortality. A total of 528 laparoscopic appendectomies were investigated with the review of data. Clinical factors for identifying PA and a comparison using computed tomography (CT) (prominent role in detection of appendicitis despite of its high cost) were done. Among the clinical factors, total duration of the symptoms before admission (cutoff value: 24.51 h, sensitivity/specificity 0.51/0.65) and highly selective C-reactive protein levels (cutoff value: 9.52 mg/L, sensitivity/specificity 0.80/0.69) had significance on PA (P=0.001) compared with the performance of CT (sensitivity/specificity 0.28/0.99). The total duration of the symptoms before admission and highly selective C-reactive protein levels were respectable predictors of PA compared with those when using CT, showing that it could be another diagnostic tool for identifying PA.
对于外科医生而言，在决定关乎降低发病率和死亡率的手术时间及方法时，准确早期诊断穿孔性阑尾炎（PA）至关重要。通过回顾数据，对总共528例腹腔镜阑尾切除术进行了研究。分析了用于识别PA的临床因素，并与计算机断层扫描（CT）（尽管成本高昂，但在阑尾炎检测中发挥重要作用）进行了比较。在临床因素中，入院前症状的总持续时间（临界值：24.51小时，灵敏度/特异度0.51/0.65）和高选择性C反应蛋白水平（临界值：9.52mg/L，灵敏度/特异度0.80/0.69）与PA具有显著相关性（P = 0.001），与CT的表现（灵敏度/特异度0.28/0.99）相比。与使用CT时相比，入院前症状的总持续时间和高选择性C反应蛋白水平是PA的可靠预测指标，表明其可作为识别PA的另一种诊断工具。
