Graham D F, Wyllie F J
Br Med J. 1979 Feb 24;1(6162):515-7. doi: 10.1136/bmj.1.6162.515.
The clinical features at presentation of 53 patients admitted with primary acute pancreatitis due to gall stones were compared with those of 31 patients in whom the disease was due to other causes. Between these two groups 10 significant differences existed. By listing the frequency of symptoms and signs for each group a computer data base was prepared and incorporated into a program used in the differential diagnosis of acute abdominal pain. A program written to predict the presence of gall stones in patients with acute pancreatitis was accurate in 92% of the patients studied. A predictive index devised from the presence of three of the significantly differing clinical features correctly identified 82% of patients with gall-stone pancreatitis. Predicting the presence of gall stones on admission by analysing the presenting symptoms and signs with a computer had an accuracy comparable to that of ultrasonography or radiology and may be of value in the management of patients with acute pancreatitis.
将53例因胆结石入院的原发性急性胰腺炎患者的临床表现与31例病因不明的患者的临床表现进行了比较。两组之间存在10个显著差异。通过列出每组症状和体征的发生频率,建立了一个计算机数据库,并将其纳入用于急性腹痛鉴别诊断的程序中。一个用于预测急性胰腺炎患者胆结石存在的程序在92%的研究患者中是准确的。根据三种显著不同的临床特征设计的预测指数正确识别了82%的胆结石性胰腺炎患者。通过计算机分析患者的症状和体征来预测入院时胆结石的存在,其准确性与超声检查或放射学检查相当,可能对急性胰腺炎患者的治疗有价值。