阑尾炎的超声诊断及漏误诊原因分析

Ultrasonic diagnosis of appendicitis and the reasons of missed diagnosis and misdiagnosis

目的探讨阑尾炎的超声诊断价值及漏误诊原因。方法回顾性分析经手术病理确诊的69例阑尾炎患者的超声声像图,分析阑尾炎超声漏误诊原因。结果69例阑尾炎,超声诊断符合率92.75%(64/69)。其中单纯性阑尾炎17.39%(12/69),化脓性阑尾炎37.68%(26/69),坏疽性及穿孔性阑尾炎14.49%(10/69),阑尾周围脓肿7.24%(5/69),慢性阑尾炎急性发作4.35%(3/69),超声间接征象提示急性阑尾炎11.59%(8/69),漏诊2例,误诊3例。结论超声对阑尾炎有较高的诊断价值。检查医师的技术、仪器质量、患者病情的复杂性及多样性是阑尾炎漏诊误诊的主要原因。

Objective To investigate the value of ultrasonic diagnosis and the reasons of missed diagnosis or misdiagnosis of appendicitis.Methods We retrospectively analyzed ultrasonogram of 69 patients with appendicitis diagnosed by surgical operation and pathology,and investigated the role of ultrasonic diagnosis and the reasons of missed diagnosis or misdiagnosis.Results In all the 69 cases,the total diagnostic coincidence rate was 92.75%;simple appendicitis account for 17.39%;suppurative appendicitis account for 37.68%;gangrenous appendicitis account for 14.49%;and appendicular abscess account for 7.24%;acute attack of chronic appendicitis account for 4.35%,ultrasound indirect signs clew appendicitis account for 11.59%.Two cases were missed diagnosed,three cases were misdiagnosed.Conclusion Ultrasound may be worthy for diagnosis of appendicitis.The main reasons of missed diagnosis or misdiagnosis are expertise of the doctor,instrument quality and the complexity and diversity of disease.