急性阑尾炎超声鉴别及漏误诊分析  

Application of Ultrasound for Differential Diagnosis in Acute Appendicitis and the Analysis of Reasons for Missed Diagnosis and Misdiagnosis

作　　者：贾莉[1] 宗华凤[2] 王希春 温爽[2] 宋涛[1] 

机构地区：[1]大连市友谊医院超声诊断科,116001 [2]大连市友谊医院病理科,116001 [3]大连市老年病医院普外科,116031

出　　处：《医学研究杂志》2013年第3期140-143,共4页Journal of Medical Research

摘　　要：目的探讨超声在急性阑尾炎鉴别诊断中的应用及漏误诊原因,进一步提高诊断准确率。方法回顾性分析103例临床疑似急性阑尾炎声像图表现,对照手术病理。结果急性阑尾炎93例,超声确诊84例,漏诊7例,误诊2例,超声诊断敏感度90.3%、特异性90.0%、准确性90.3%、漏诊率7.5%、误诊率2.2%。非急性阑尾炎10例,超声确诊9例,误诊1例,超声鉴别诊断准确率90.0%(9/10)。结论 急性阑尾炎超声鉴别诊断具有重要价值,密切结合临床拓宽超声检查思路是减少漏误诊的关键。Objective To investigate the value of ultrasound for differential diagnosis in acute appendicitis, and to summarize the reasons of missed diagnosis and misdiagnosis, so as to further improve the diagnostic accuracy. Methods The sonograms of 103 cases suspected clinically as acute appendicitis were retrospectively analyzed and compared with operation and pathology. Results Totally 93 cases of acute appendicitis were proved. 84 cases were diagnosed correctly by preoperative ultrasound, 7 cases were missed diagnosed, 2 cases were misdiagnosed. The sensitivities, specificities, accuracies, missed diagnosis rate and misdiagnosis rate of ultrasound in the di- agnosis of acute appendicitis were 90.3% , 90.0% , 90.3% , 7.5% and 2.2% , respectively. Ten cases of non - acute appendicitis were proved. 9 cases were diagnosed correctly by ultrasound, and 1 cases were misdiagnosed. The differential diagnosis concordance rate was 90.0% （9/10） in non -acute appendicitis. Conclusion Ultrasound has important value for differential diagnosis of acute appendicitis. Marriage with clinic and broadening the ultrasound examination ideas are the keys of reducing missed diagnosis and misdiagnosis.

关 键 词：急性阑 尾炎 超声 鉴别诊断 漏诊 误诊 

分 类 号：R581.3[医药卫生—内分泌]