捏提试验在急性阑尾炎诊断中的价值

Application of Pinch-an-inch test in diagnosis of acute appendicitis

目的探讨捏提试验在急性阑尾炎诊断中的价值。方法2008年1月至2010年12月拟诊急性阑尾炎并行阑尾切除术的病人323例，体检时均行捏提试验、Rovsing征及Markle征，分别计算特异性、敏感度及阳性预测值；并比较捏提试验阳性和阴性病人之间阴性阑尾切除率。结果捏提试验的特异性和敏感度分别为80．9％和75．7％；捏提试验的阳性预测值为95．9％，高于Rovs—ing征（87．3％）及Markle征（92．0％）；捏提试验阳性病人的阴性阑尾切除率为4．1％，捏提试验阴性病人的阴性阑尾切除率为36．2％，两者比较，差异有统计学意3L（X^2=43．46，P〈0．05）。结论应用捏提试验能提高急性阑尾炎的诊断率，显著降低阴性阑尾切除率。

Objective To study the-application of pinch-an-inch test in the diagnosis of acute appendicitis. Methods We prospectively studied 323 patients with acute appendicitis from Jan. 2008 to Dec. 2010. All patients were subjected to pinch-an-inch test, Rovsing sign and Markle sign. The sensitivity, specificity and positive predictive value were analyzed. The negative appendectomy rate was compared between the pinch-an-inch positive and negative groups. Results The sensitivity and specificity of pinch-an-inch test was 80. 9% and 75.7% ;The positive predictive value of pinch-an-inch was 95.9 %; There was significant difference in the negative appendectomy rate between the pinch-an-inch positive （4. 1%） and negative（36. 2 %） groups. Conclusion The application of pinch-an-inch test can improve diagnosis accuracy of acute appendicitis, and reduce the negative appendectomy rate.