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超声波墨菲标志:镇痛是否重要?

Elianna L Goldstein¹, Karina R Marcelo², William R Harjes³

¹Department of Radiology, California Advanced Imaging Medical Associates, San Francisco, CA, USA.

Emergency radiology

|September 24, 2025

概括

在右上象限超声波之前的阿片类药物镇痛可能会增加错误负的急性胆囊炎诊断. 非阿片类药物止痛是一种可行的替代方案,可保持腹痛评估的诊断准确性.

科学领域:

紧急医疗紧急医疗
放射学放射学是一门学科.
胃肠病学胃肠病学

背景情况:

在对急性胆囊炎 (AC) 评估的右上象限超声波 (RUQUS) 之前使用止痛药是有争议的.
阿片类药物镇痛 (OA) 可能会掩盖超声波的诊断结果.

研究的目的:

调查阿片类止痛药 (OA) 和非阿片类止痛药 (NOA) 对超声波墨菲标志的影响.
通过RUQUS确定OA和NOA对急性胆囊炎 (AC) 诊断准确性的影响.

主要方法:

对686名成年患者的回顾性队列图表审查.
对OA与对照组进行AC诊断的比较.
在AC诊断中,NOA与对照组的比较.

主要成果:

阿片类药物镇痛 (OA) 显著增加了不确定的超声波墨菲征兆和错误阴性AC诊断 (7.9%与3.0%相比).
与对照组相比,非阿片类药物止痛疗法 (NOA) 在假阴性AC率上没有显著差异 (4.6%对3.7%).
在RUQUS后30分钟内接受OA或低剂量OA (<4毫克吗啡相当量) 的患者有更高的错误阴性AC诊断率.

结论:

推延迟阿片类药物止痛 (OA) 直到RUQUS后或至少30分钟后给药,以减轻虚假阴性结果.
非阿片类药物止痛疗法 (NOA) 提供了一个安全有效的替代方案,用于在RUQUS期间进行AC评估的疼痛管理,而不会影响诊断的准确性.

关键词:

止痛药止痛药是一种止痛药.胆囊炎是一种胆囊炎.在阿片类药物中,阿片类药物超声波墨菲标志的标志

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