在急性腹痛中,发病特征与时间到峰值评估的诊断性能
Toshihiko Takada1, Ryuji Suzuki2, Hiroshi Honjo3
1Department of General Medicine, Shirakawa Satellite for Teaching and Research (STAR), Fukushima Medical University, Shirakawa, Fukushima, Japan. ttakada@water.ocn.ne.jp.
Journal of general internal medicine
|December 8, 2025
概括
评估急性腹痛的疼痛开始是关键. 时间到峰值评估显示,对于关键条件的特异性比突然发作的特征性更高,有助于诊断,但不排除所有紧急情况.
科学领域:
- 紧急医疗 紧急医疗
- 诊断的准确性 诊断的准确性
- 腹部疼痛评估 腹部疼痛评估
背景情况:
- 准确评估症状发作对于诊断急性腹痛和识别危及生命的疾病至关重要.
- 在急性腹痛中评估疼痛发作的最佳方法尚不清楚.
研究的目的:
- 为了比较两种历史记录方法的诊断性能,以评估急性腹痛中的疼痛发作.
- 为了确定时间到高峰的评估是否优于突然发作的表征来识别关键的腹内疾病.
主要方法:
- 在日本的一家急症医院进行的前性诊断研究.
- 评估了长达7天或更短时间的腹痛的成年患者.
- 主要结局是CT或临床随访确认的目标状况 (破裂,剖析,血管封闭,扭曲或穿孔) 的存在.
主要成果:
- 时间到峰值评估显示,在确定目标条件时,与突然发作特征 (86.7%) 相比,具有更高的特异性 (94.3%).
- 这两种方法的灵敏度并没有显著差异 (40.0%用于突然发作,而30.0%用于时间到高峰).
- 在629名患者中,20名 (3.2%) 被诊断出患有目标疾病.
结论:
- 在急性腹痛患者中,时间到峰值评估提供了更好的特异性,以裁决急性腹痛患者的关键腹内疾病.
- 无论是突然发作的特征,还是时间到峰值的评估,都不足以排除危及生命的疾病.
- 进一步的研究可能会探索将这些方法或其他诊断工具结合起来进行全面评估.
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