Adedeji O A, McAdam W A
Department of Surgery, Airedale General Hospital, Keighley, West Yorkshire.
J R Coll Surg Edinb. 1996 Apr;41(2):88-9.
The presentation of acute abdomen in elderly people differs from that in younger patients. We retrospectively assessed how the presence or absence of Murphy's sign affected initial diagnosis of acute cholecystitis in elderly patients. In the presence of Murphy's sign, diagnostic accuracy for acute cholecystitis was 80% dropping to 34% when the sign was negative. The positive predictive value of the test in elderly people was 0.58, with a sensitivity of 0.48 and a specificity of 0.79. In elderly patients, a positive Murphy's sign is useful, but a negative sign should be treated with caution and other diagnostic tests and promptly. There should be cautious interpretation of classical signs in elderly patients.
老年人急腹症的表现与年轻患者不同。我们回顾性评估了墨菲氏征的有无如何影响老年患者急性胆囊炎的初步诊断。存在墨菲氏征时，急性胆囊炎的诊断准确率为80%，该体征为阴性时则降至34%。该检查在老年人中的阳性预测值为0.58，敏感性为0.48，特异性为0.79。在老年患者中，墨菲氏征阳性是有用的，但阴性结果应谨慎对待，并及时进行其他诊断检查。对老年患者的典型体征应有谨慎的解读。
