Morcos R, Frost N, Hnat M, Petrunak A, Caldito G
Department of Obstetrics and Gynecology, St. Elizabeth Hospital Medical Center, Youngstown, Ohio.
J Reprod Med. 1993 Jan;38(1):53-6.
The purpose of this study was to evaluate the accuracy of clinical diagnosis of acute pelvic inflammatory disease (PID). Data were obtained on 176 consecutive women admitted to St. Elizabeth Hospital Medical Center with a clinical diagnosis of PID. All underwent diagnostic laparoscopy. PID was established laparoscopically in 134 (76.1%) of the patients. Statistical tests for significant associations between PID and each of 21 clinical indicators of the disease were conducted using the chi 2 and Mann-Whitney tests. Stepwise logistic regression was performed on those variables whose univariate tests of significant association with PID resulted in P values < 0.20. An optimal set of PID indicators consisted of adnexal tenderness, lower abdominal pain of < one week's duration and an elevated white blood cell count. Use of these indicators resulted in a test with an estimated sensitivity and specificity of 86.6% and 45.7%, respectively. Estimated predictive values for positive and negative test results were 0.84 and 0.52, respectively. These results confirm the fact that laparoscopy is the definitive diagnostic modality in PID.
本研究的目的是评估急性盆腔炎（PID）临床诊断的准确性。收集了连续176例因临床诊断为PID而入住圣伊丽莎白医院医疗中心的女性患者的数据。所有患者均接受了诊断性腹腔镜检查。经腹腔镜检查确诊为PID的患者有134例（76.1%）。使用卡方检验和曼-惠特尼检验对PID与该疾病21项临床指标中的每一项之间的显著相关性进行统计学检验。对那些与PID的单变量显著相关性检验P值<0.20的变量进行逐步逻辑回归分析。一组最佳的PID指标包括附件压痛、持续时间<1周的下腹部疼痛和白细胞计数升高。使用这些指标进行检测，估计敏感性和特异性分别为86.6%和45.7%。阳性和阴性检测结果的估计预测值分别为0.84和0.52。这些结果证实了腹腔镜检查是PID的确定性诊断方法这一事实。
