Leake R A
J R Coll Gen Pract. 1985 Aug;35(277):372-4.
An investigation into the diagnosis of gall-bladder disease in general practice by simple clinical methods was carried out over seven years; 916 patients were seen in 1018 episodes of illness. These patients were examined particularly for oedema in the skin and subcutaneous tissue of the right hypochondrium, Murphy's sign, clinical jaundice and bilirubinuria.Oedema was found in 89% of the episodes of confirmed gall-bladder disease and in 74% of the suspected cases, but in only 4% of the other abdominal and thoracic conditions studied. Clinical jaundice or bilirubinuria or both occurred in 28% of the confirmed episodes of gall-bladder disease and in 12% of the suspected ones.If oedema, Murphy's sign and jaundice were all present there was a 72% probability of the condition being gall-bladder disease.During the study, there was a 45% increase in the number of new cases of gall-bladder disease correctly diagnosed each year compared with the previous three and a half years, and an 89% decrease in the number of cases missed.
一项针对普通诊所中通过简单临床方法诊断胆囊疾病的研究持续了七年；在1018次发病过程中观察了916名患者。对这些患者特别检查了右季肋区皮肤和皮下组织的水肿、墨菲氏征、临床黄疸和胆红素尿。在确诊的胆囊疾病发作中，89%发现有水肿，疑似病例中74%有水肿，但在所研究的其他腹部和胸部疾病中只有4%有水肿。临床黄疸或胆红素尿或两者都出现的情况在确诊的胆囊疾病发作中占28%，在疑似病例中占12%。如果水肿、墨菲氏征和黄疸都存在，那么该病症为胆囊疾病的概率为72%。在研究期间，与前三年半相比，每年正确诊断出的胆囊疾病新病例数量增加了45%，漏诊病例数量减少了89%。
