在超声波中出现非可视化尾的病例实际上不是尾炎吗? 单一中心的结果
Mehmet Eşref Ulutaş1, Eray Balcı2, İsmail Hasırcı3
1Department of General Surgery, University of Health Sciences, Gaziantep City Hospital, Gaziantep, Turkey.
Journal of clinical ultrasound : JCU
|December 22, 2024
概括
当超声波上无法看到尾时,急性尾炎 (AA) 诊断,低白细胞计数和阿尔瓦拉多得分低于6表明它不太可能. 这一发现可以帮助避免不必要的高级成像,如CT扫描.
科学领域:
- 放射学 放射学是一门学科.
- 紧急医疗 紧急医疗
- 手术诊断手术诊断的使用方法
背景情况:
- 超声波 (USG) 是诊断急性尾炎 (AA) 的主要成像方法.
- 然而,在许多情况下,USG可能无法可视化附件.
- 这就需要评估替代诊断途径和成像策略.
研究的目的:
- 追溯分析患者的临床,成像和病理学数据,这些患者的尾在USG上没有可视化.
- 指导临床医生在初始超声波图无法确定时,在诊断急性尾炎时采取适当的下一步.
- 在这些具有挑战性的病例中,确定可以帮助区分尾炎和其他疾病的因素.
主要方法:
- 对176名疑似急性尾炎 (AA) 的患者 (2021年1月至2021年12月) 的回顾性分析,在初始超声波 (USG) 上没有可视化尾炎.
- 审查了临床,成像 (包括计算机断层扫描 - - CT) 和病理学结果.
- 根据CT是否进行和最终诊断 (AA或其他) 的情况,患者进行了比较.
主要成果:
- 在176名患者中,15名 (8.5%) 被病理诊断为AA. 两名没有CT出院的患者后来被诊断为AA.
- 被诊断为AA的患者的白细胞 (WBC) 计数显着更高 (13.4 vs 10.3 × 10^3/mL,p=0.009) 和阿尔瓦拉多分数≥6的比例更高 (80% vs 4.3%,p<0.001).
- 44.9%的患者进行了计算机断层扫描 (CT),而55.1%的患者没有接受CT.
结论:
- 在USG上没有可视化尾的情况下,白细胞不存在 (白细胞数增加) 和阿尔瓦拉多分数低于6可能表明急性尾炎 (AA) 的可能性较低.
- 这些临床和实验室发现可能有助于临床医生避免进一步的CT或MRI等调查.
- 这种方法可以优化资源利用,并减少患者暴露于辐射.
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