难治性肛瘘三种诊断方法的一致性分析研究

Consistency Analysis of Three Diagnosis Methods in Treating Fistula Difficulty to Cure

目的:分析规范的局部体征检查,肛周超声,术中探查三种诊断方法对难治性肛瘘诊断的一致性。方法:观察180例难治性肛瘘病例,均予三联诊断法,即规范的局部体征检查,肛周超声,术中探查三种方法分别对肛瘘瘘管数目、走行情况检查。再通过专业的统计分析,分析三种诊断方法之间的一致性。结果:通过Kappa检验,发现肛周超声与术中探查分析结果一致性较高,而局部体征检查与术中探查一致性较差。因而超声检查均明显优于局部体征检查,有显著性差异。结论:在难治性肛瘘中,肛周超声检查与术中探查一致性较高,而局部体征检查与术中探查一致性较低,但局部体征检查是临床诊断中不可缺少的。将三者结合应用,探索出经济有效的提高难治性肛瘘的检出率的科学方法。

Objective： To analysis the consistency of three diagnosis methods in treating fistula difficulty to cure. Methods： 180 cases were given anus examination, anus ultrasound and exploration in surgery in order. And analyze the correlation of three diagnosis methods through special statistics. Results： According to Kappa analysis, we found that anus ultrasound was better than anus examination in diagnosing fistula, the difference had statistic significance. Conclusion： Anus ultrasound was better than anus examination in diagnosing fistula.