Gao Ming, Chen Qingshan, Gong Jin, Lao Xuejun, Tong Ka Wai, Wang Cunchuan
Department of General Surgery, the First Affiliated Hospital, Jinan University, Guangzhou 510630, China.
Zhonghua Wei Chang Wai Ke Za Zhi. 2014 Dec;17(12):1220-2.
To compare the applied value of the pressure aggravation test and breath aggravation test in the diagnosis of early acute appendicitis.
A total of 101 cases with epigastralgia, middle or upper abdomen pain, disease duration within 6 hours undergoing pressure aggravation test and breath aggravation test respectively in our hospital between October 2010 and December 2012 were prospectively enrolled. By comparing with the postoperative pathological diagnosis (early acute appendicitis and other abdominal pain), the sensitivity and specificity of these two tests were calculated. Through analyzing the receiver operating characteristic (ROC) curve, the diagnostic value of early acute appendicitis was evaluated.
Fifty-two cases of early acute appendicitis and 49 cases of other abdominal pain were diagnosed by postoperative pathologic results. The sensitivity and specificity of the pressure aggravation test were 87.5% and 72.1% and of the breath aggravation test were 53.8% and 83.7% respectively. The area under the ROC curve of the pressure aggravation test was 0.786 (95% CI: 0.693-0.878), similar to that of the breath aggravation test (0.688, 95% CI: 0.583-0.792).
The pressure aggravation test has higher value to diagnose early acute appendicitis, while the breath aggravation test has better specificity.
比较压痛加剧试验与呼吸加剧试验在早期急性阑尾炎诊断中的应用价值。
前瞻性纳入2010年10月至2012年12月期间在我院分别接受压痛加剧试验和呼吸加剧试验的101例上腹部疼痛、中上腹疼痛、病程在6小时以内的患者。通过与术后病理诊断(早期急性阑尾炎和其他腹痛)进行比较,计算这两种试验的敏感性和特异性。通过分析受试者工作特征(ROC)曲线,评估早期急性阑尾炎的诊断价值。
术后病理结果诊断出52例早期急性阑尾炎和49例其他腹痛。压痛加剧试验的敏感性和特异性分别为87.5%和72.1%,呼吸加剧试验的敏感性和特异性分别为53.8%和83.7%。压痛加剧试验的ROC曲线下面积为0.786(95%CI:0.693 - 0.878),与呼吸加剧试验(0.688,95%CI:0.583 - 0.792)相似。
压痛加剧试验对早期急性阑尾炎的诊断价值较高,而呼吸加剧试验具有较好的特异性。