过去十年来盲肠误诊案例没有改善

令人惊讶地,先进的医疗诊断检测没有改善诊断失误

  根据一项在十月十日的The Journal of the American Medical Association研究报告显示,虽然在仍然存疑的盲肠炎案例上已大量使用先进的诊断检测技术,但在1987至1998年间,不必要的盲肠切除术仍没有递减的趋势。在这份来自西雅图华盛顿大学的回顾性、以人口分类为根据的研究中,六万三千七百零七位病患接受了非必要的盲肠切除术。在这之中,百分之八十四点五的患者有盲肠炎,包括了百分之二十五点八的患者有穿孔的现象,但仍有百分之十五点五的患者没盲肠炎。

Misdiagnosis of Appendicitis Unchanged Over Last Decade

Surprisingly, Advanced Diagnostic Testing Has Not Improved Diagnosis

By Laurie Barclay, MD
WebMD Medical News

Reviewed by Charlotte E. Grayson, MD

Oct. 10, 2001 -- Despite widespread use of advanced diagnostic testing in equivocal cases of appendicitis, incidence of unnecessary appendectomy has not changed much from 1987 to 1998, according to a study in the Oct. 10 issue of The Journal of the American Medical Association.

In this retrospective, population-based cohort study from the University of Washington in Seattle, 63,707 patients had non-incidental appendectomy. Of these, 84.5% had appendicitis, including 25.8% with evidence of perforation, but 15.5% had no evidence of appendicitis.

After adjusting for age and sex, the population-based incidence of unnecessary appendectomy and of appendicitis with perforation did not change significantly over the study period from 1987 to 1998. Misdiagnosis actually increased in women of child-bearing age by 1% per year (p=0.005) and by 8% yearly in patients over 65 (p<0.001) but was unchanged in children under 5. Relative to patients who had open appendectomy, more patients who had laparoscopic appendectomy were misdiagnosed (19.5% vs. 15.5%; p<0.001).

"Contrary to expectation, the frequency of misdiagnosis leading to unnecessary appendectomy has not changed with the introduction of computed tomography, ultrasonography, and laparoscopy, nor has the frequency of perforation decreased," the authors write.

© 2001 WebMD Corporation. All rights reserved.

    
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