Alyono D, Perry J F
Surgery. 1982 Jun;91(6):656-9.
The value of repeating diagnostic peritoneal lavage (DPL) when initial results are indeterminate or negative has not been defined. From January 1974 to June 1980, 1884 patients underwent DPL. Ninety-six had repeat DPL. Eighty-eight (4.7%) patients with indeterminate initial DPL results had repeat DPL. Results were true positive in 20, false positive in non, false negative in three, and true negative in 64 patients. If results for all 88 patients had initially been considered positive and all had undergone operation, the additional yield would have been low, three patients (3.4%); 64 patients would have undergone unnecessary laparotomy. If all 88 results had been considered negative, 20 patients (23%) with intra-abdominal injuries would have been diagnosed late or not at all. Eight patients with initial negative DPL but with persistent abdominal pain underwent repeat DPL. Results were true positive in three, false negative in one, and true negative in four. Repeat lavage has an accuracy of 95.8%, sensitivity of 85.2%, and specificity of 100%; with repeat lavage, DPL overall has high accuracy (98.4%), sensitivity (94.2%), and specificity (99.7%). Repeat lavage can be helpful in evaluating patients with initial negative lavage but with persistent abdominal pain. Repeat lavage is also indicated when initial results are indeterminate.
当初次诊断性腹腔灌洗（DPL）结果不确定或为阴性时，重复进行DPL的价值尚未明确。1974年1月至1980年6月，1884例患者接受了DPL。其中96例进行了重复DPL。初次DPL结果不确定的88例（4.7%）患者进行了重复DPL。结果显示，20例为真阳性，无一例假阳性，3例假阴性，64例为真阴性。如果最初将所有88例患者的结果都视为阳性并全部进行手术，额外的阳性率会很低，仅3例（3.4%）；64例患者将接受不必要的剖腹手术。如果将所有88例结果都视为阴性，20例（23%）有腹腔内损伤的患者将被延迟诊断或根本无法诊断。8例初次DPL结果为阴性但持续腹痛的患者接受了重复DPL。结果显示，3例为真阳性，1例假阴性，4例为真阴性。重复灌洗的准确率为95.8%，敏感度为85.2%，特异度为100%；加上重复灌洗，DPL总体的准确率较高（98.4%）、敏感度（94.2%）和特异度（99.7%）。重复灌洗有助于评估初次灌洗结果为阴性但持续腹痛的患者。当初次结果不确定时，也需要进行重复灌洗。
