CAJ | 학술논문

目的：评价按压疼痛加剧试验和呼吸疼痛试验对于早期急性阑尾炎的诊断价值。方法前瞻性入组2010年10月至2012年12月间暨南大学附属第一医院收治的101例发病时间在6h以内的上腹或中上腹部疼痛患者，分别进行按压疼痛加剧试验和呼吸疼痛试验，通过与术后病理诊断结果（早期急性阑尾炎或非阑尾炎腹痛）进行对比，来计算两种试验方法的灵敏度和特异度，并通过绘制受试者工作特征（ROC）曲线来分析其对早期急性阑尾炎的诊断价值。结果52例患者经术后病理证实为早期急性阑尾炎，另49例为非阑尾炎腹痛。按压疼痛加剧试验诊断早期急性阑尾炎的灵敏度和特异度分别为87．5％和72．1％，呼吸疼痛试验分别为53．8％和83．7％。按压疼痛加剧试验的ROC曲线下面积为0．786（95％ CI：0．693～0．878），略高于呼吸疼痛试验的0．688（95％ CI：0．583～0．792）。结论按压疼痛加剧试验对于早期急性阑尾炎具有较高的诊断价值，但特异度不如呼吸疼痛试验。
목적：평개안압동통가극시험화호흡동통시험대우조기급성란미염적진단개치。방법전첨성입조2010년10월지2012년12월간기남대학부속제일의원수치적101례발병시간재6h이내적상복혹중상복부동통환자，분별진행안압동통가극시험화호흡동통시험，통과여술후병리진단결과（조기급성란미염혹비란미염복통）진행대비，래계산량충시험방법적령민도화특이도，병통과회제수시자공작특정（ROC）곡선래분석기대조기급성란미염적진단개치。결과52례환자경술후병리증실위조기급성란미염，령49례위비란미염복통。안압동통가극시험진단조기급성란미염적령민도화특이도분별위87．5％화72．1％，호흡동통시험분별위53．8％화83．7％。안압동통가극시험적ROC곡선하면적위0．786（95％ CI：0．693～0．878），략고우호흡동통시험적0．688（95％ CI：0．583～0．792）。결론안압동통가극시험대우조기급성란미염구유교고적진단개치，단특이도불여호흡동통시험。
Objective To compare the applied value of the pressure aggravation test and breath aggravation test in the diagnosis of early acute appendicitis. Methods A total of 101 cases with epigastralgia, middle or upper abdomen pain, disease duration within 6 hours undergoing pressure aggravation test and breath aggravation test respectively in our hospital between October 2010 and December 2012 were prospectively enrolled. By comparing with the postoperative pathological diagnosis (early acute appendicitis and other abdominal pain), the sensitivity and specificity of these two tests were calculated. Through analyzing the receiver operating characteristic (ROC) curve, the diagnostic value of early acute appendicitis was evaluated. Results Fifty-two cases of early acute appendicitis and 49 cases of other abdominal pain were diagnosed by postoperative pathologic results. The sensitivity and specificity of the pressure aggravation test were 87.5% and 72.1% and of the breath aggravation test were 53.8% and 83.7% respectively. The area under the ROC curve of the pressure aggravation test was 0.786 (95% CI: 0.693-0.878), similar to that of the breath aggravation test (0.688, 95% CI: 0.583-0.792). Conclusion The pressure aggravation test has higher value to diagnose early acute appendicitis, while the breath aggravation test has better specificity.