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目的评价超声诊断急性阑尾炎的临床应用价值。方法随机抽取在临床上连续疑诊急性阑尾炎来做超声检查的患者,以手术所见和病理检查为确诊的标准(排除标准是手术、其他检查或临床经过),将超声检查结果与之对照,按着四格表法,计算有关真实性的评价指标。结果受检对象185例,其中急性阑尾炎患者103例,非阑尾炎患者82例;超声诊断结果阳性(诊为急性阑尾炎)94例,阴性91例。超声诊断急性阑尾炎的灵敏度为85%,特异度93%,漏诊率15%,误诊率7%,准确度89%,阳性似然比12.14,阴性似然比0.16。在本研究患病率为56%的情况下,阳性预告值为94%,阴性预告值86%。化脓性阑尾炎和阑尾周围脓肿的检出率显著高于单纯性阑尾炎,差异有统计学意义(P<0.05)。结论超声诊断急性阑尾炎的真实性较好,但漏诊率偏高。
Objective To evaluate the clinical value of ultrasonic diagnosis of acute appendicitis. Methods The patients who were diagnosed with acute appendicitis consecutively in clinic were selected randomly. The patients who were diagnosed by surgery and pathological examination (exclusion criteria were surgery, other examinations or clinical trials) were compared with the results of ultrasound examination. According to the four grid table method, calculate the evaluation index of authenticity. Results 185 subjects were examined, including 103 cases of acute appendicitis and 82 cases of non-appendicitis; 94 cases were diagnosed as acute appendicitis (diagnosis of acute appendicitis) and 91 cases were negative. The sensitivity of ultrasonography in the diagnosis of acute appendicitis was 85%, specificity was 93%, misdiagnosis rate was 15%, misdiagnosis rate was 7%, accuracy was 89%, positive likelihood ratio was 12.14, negative likelihood ratio was 0.16. In the case of 56% prevalence in this study, the positive predictive value was 94% and the negative predictive value was 86%. The detection rate of suppurative appendicitis and appendix abscess was significantly higher than that of simple appendicitis, the difference was statistically significant (P <0.05). Conclusion The diagnosis of acute appendicitis by ultrasound is better, but the rate of misdiagnosis is higher.