Caterino S, Meli C, Capotondi C, Cavallini M, Zerilli M, Schiffino L, Murante G, Alessi G, Cavallaro A
Università degli Studi di Roma La Sapienza, I Istituto di Clinica Chirurgica.
Ann Ital Chir. 1995 Jan-Feb;66(1):87-97; discussion 97-8.
A prospective study was carried out to compare the value of ultrasound examination with conventional management in patients presenting with emergency surgical problems. During an 4 years period the authors followed 301 patients referred to the Ist Institute of Surgery of the University of Rome "La Sapienza". After immediate clinical evaluation one or more US examinations were performed in each patient following a standard protocol of study. Abdominal emergencies were the most frequent conditions, found in 75% of the cases and the acute abdomen due to trauma in 17.6% of the cases. The overall sensibility, specificity and accuracy of clinical examinations and US examinations were respectively of 88%, 33%, 70% and 95%, 94%, 95%. In 38 patients (12.7%), a diagnosis was made up by sonographic examination which had not been clinically expected (group A). The principal condition in this group was gynaecological pathology, found in 17 patients. In 161 patients (53.3%) sonography confirmed the first diagnosis clinically suspected (group B) and in 23 cases the second or third differential diagnosis (group D). Sonography made no contribution to the diagnosis in 77 cases (25,5%) and only in 2 cases was considered misleading. The result of this study demonstrate the usefulness of emergency ultrasonography in gynecological, gall bladder, pancreatic and vascular diseases. Moreover sonography must be considered the principal diagnostic tool in patients with trauma. In order to recognize gynecological diseases which can simulate appendicitis US examination must be considered necessary in young female patients. When appendicitis is suspected US is useful in children and in older patients too.
开展了一项前瞻性研究，以比较超声检查与传统管理方法对出现紧急外科问题患者的价值。在4年期间，作者跟踪了301例转诊至罗马大学“La Sapienza”第一外科研究所的患者。在进行即刻临床评估后，按照标准研究方案对每位患者进行了一次或多次超声检查。腹部急症是最常见的情况，75%的病例中出现，17.6%的病例是由创伤导致的急腹症。临床检查和超声检查的总体敏感性、特异性和准确性分别为88%、33%、70%以及95%、94%、95%。在38例患者（12.7%）中，超声检查做出了临床未预期的诊断（A组）。该组的主要病症是妇科疾病，见于17例患者。在161例患者（53.3%）中，超声检查证实了临床怀疑的初步诊断（B组），在23例中证实了第二或第三鉴别诊断（D组）。超声检查在77例（25.5%）中对诊断无帮助，仅在2例中被认为有误导性。本研究结果表明急诊超声检查在妇科、胆囊、胰腺和血管疾病中有用。此外，超声检查必须被视为创伤患者的主要诊断工具。为了识别可能模拟阑尾炎的妇科疾病，对于年轻女性患者必须进行超声检查。当怀疑阑尾炎时，超声检查对儿童和老年患者也有用。
