腹部平片诊断成人肠梗阻价值的Meta分析  

Abdominal Plain Film Diagnosis in Adult Intestinal Obstruction: A Meta-analysis

作　　者：李德秀[1] 赵益林[1] 赵年[1] 

机构地区：[1]湖北医药学院附属东风医院影像科,湖北十堰442008

出　　处：《医学综述》2015年第22期4149-4152,共4页Medical Recapitulate

摘　　要：目的 评价腹部平片对成人肠梗阻的诊断价值.方法 搜集现有国内公开发表的以手术或病检结果为诊断金标准的关于腹部平片诊断成人肠梗阻的中文文献,按照Meta分析的要求和诊断性试验公认的质量标准对所有纳入研究进行质量评估,并提取各纳入研究的特征信息.采用STATA 10.0软件检验异质性,根据异质性结果选择相应的效应模型,应用MetaDisc 1.4软件计算出汇总灵敏度和特异度,以诊断性试验Meta分析特有的综合受试者工作特征（SROC）曲线分析方法定性、定量地评价该诊断方法的准确性.结果 符合纳入标准的文献共14篇,汇总的诊断指标和SROC分析显示,腹部平片的诊断均有较高的诊断效能,表示诊断试验准确度的指标汇总灵敏度为0.90（95％ CI0.88 ～0.92）,汇总特异度为0.48（95％ CI0.42～0.55）,曲线下面积为0.9104,Q指数为0.8426.结论 汇总目前关于腹部平片诊断成人肠梗阻的研究显示,腹部平片是一种灵敏度较高的检查方法,但特异度较低,可作为筛查手段.Objeetive To evaluate the value of abdominal plain film in the diagnosis of adult intestinal obstruction. Methods All the published papers concerning the diagnosis of intestinal obstruction using abdominal plain film in Chinese were searched and reviewed, and the studies with the surgery or pathology as the gold standard were adopted as eligible. Statistical analysis was performed by STATA（ vision 10. 0） and MetaDisc（ vision 1.4 ）. Heterogeneity of the included articles was tested, which was used to select proper effect model to calculate pooled weighted sensitivity, specificity and accuracy. Performance of abdominal plain film test was assessed with summary receiver operating characteristic curve（SROC） analysis, with independ- ently pooled sensitivity and specificity values across studies. Results Totally 14 studies met the inclusion criteria. The pooled indexes of diagnostic performance and SROC demonstrated a high discriminatory power for detecting intestinal obstruction by abdominal plain film. Our pooled estimates for sensitivity was 0. 90 （95 % CI O. 88 to 0. 92 ） ; pooled estimates for specificity was 0. 48 （ 95 % CI 0. 42 to 0. 55 ） , area under curve（AUC） =0. 9104 and Q ＊ =0. 8426. Conclusion Abdominal plain film is a highly sensitive diagnostic tool for detecting intestinal obstruction in adult, but it has low specificity, therefore can be used as a screening tool.

关 键 词：肠梗阻 X线 手术 病理 统计学 

分 类 号：R445.4[医药卫生—影像医学与核医学]