改善疑似急性尾炎患者管理的时间:一项回顾性研究
Anita Paisant1,2,3, Emma Faroche1,4, Alban Fouche1
1Faculty of Health, Department of Medicine, Angers, France.
Abdominal radiology (New York)
|July 2, 2024
概括
建议在怀疑急性尾炎 (AA) 时进行超声波 (US) 和计算机断层扫描 (CT). 这项研究发现,US是一种高效的第一线测试,CT增加了急诊室停留时间.
科学领域:
- 紧急医疗 紧急医疗
- 放射学 放射学是一门学科.
- 手术病理学手术病理学
背景情况:
- 怀疑急性尾炎 (AA) 的术前成像是世界紧急手术协会推的.
- 评估超声波 (US) 和计算机断层扫描 (CT) 在管理AA方面的效率对于优化患者护理至关重要.
- 了解当地实践和诊断绩效指标有助于临床决策.
研究的目的:
- 描述使用US和/或CT用于疑似AA的当地实践模式.
- 评估US和CT在AA管理中的诊断效率.
- 评估管理失败率,诊断准确度 (敏感度和特异性),以及急诊室 (ED) 停留时间.
主要方法:
- 一个单一中心的回顾性研究包括2012年至2021年2月至6月期间被怀疑AA入院的患者.
- 收集了对接受US或CT进行AA诊断的患者的数据.
- 分析了管理失败,敏感性,特异性和ED停留时间.
主要成果:
- 在339名患者中,82%接受了US,其中31.3%接受了二线CT.CT利用率随着时间的推移而增加.
- 管理失败发生在3%的患者中;年龄较大和CT/US+CT与更高的风险有关.
- 美国的敏感度为84.8%,特异性为93.2%. CT显示了100%的灵敏度和87.9%的特异性. 第二线CT显著增加了ED停留时间.
结论:
- 超声波应该被认为是一个系统的,第一线检查怀疑急性尾炎,当可用与CT.
- 美国在诊断AA时表现出高灵敏度和特异性.
- 虽然CT提供了更高的灵敏度,但其作为二线测试的使用会延长ED停留时间.
相关概念视频
01:29Appendicitis-II: Diagnostic Studies and Management
74
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
74
01:22Appendicitis-I: Introduction
106
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
106
01:30Acute Pancreatitis II: Clinical Manifestations and Management
118
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
118
01:29Chronic Pancreatitis II: Collaborative Care
84
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
84
01:26Flail Chest-II
162
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History:
162
01:14SBAR II: Application of SBAR
4.4K
SBAR is an effective communication tool used by healthcare professionals to communicate patient information accurately. SBAR stands for Situation, Background, Assessment, and Recommendation. For a better understanding, an example is given below.
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
4.4K