Reymond M A, Merlini M, Tschantz P, Groebli Y
Département de chirurgie, Hôpital, La Chaux-de-Fonds.
Helv Chir Acta. 1994 Apr;60(4):647-51.
A decisional protocol based on clinical findings and laboratory data was assessed prospectively in a consecutive series of 120 patients with suspected appendicitis over a 24-month period at 2 teaching hospitals. Using this protocol the high rate of negative appendectomy (31.5%) during the 2 years prior to the study was reduced to 22% without increasing morbidity or mortality. Ultrasound examination was poorly predictive in unclear cases. Laparoscopy was used to assess diagnosis in persistent symptoms.
在两家教学医院对连续120例疑似阑尾炎患者进行了为期24个月的前瞻性评估,该评估基于临床发现和实验室数据制定了决策方案。使用该方案,研究前两年高达31.5%的阴性阑尾切除率降至22%,且未增加发病率或死亡率。在情况不明的病例中,超声检查的预测效果不佳。对于持续有症状的患者,采用腹腔镜检查来评估诊断。