급성충수염 진단에서 CT와 비교한 Alvarado Score의 효용 분석

이성민; 장인택; 김범규; 차성재; 김용석; 박준석

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자료유형: 학술저널

저자정보: 이성민 (중앙대학교) 장인택 (중앙대학교) 김범규 (중앙대학교) 차성재 (중앙대학교) 김용석 (성균관대학교) 박준석 (경북대학교병원)

저널정보: 대한대장항문학회 Annals of Coloproctology Annals of Coloproctolgy Vol.24 No.1

발행연도: 2008.1

수록면: 1 - 6 (6page)

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이 논문의 연구 히스토리 (2)

2008

급성충수염 진단에서 CT와 비교한 Alvarado Score의 효용 분석

이성민 , 장인택 , 김범규 외 3명 Annals of Coloproctology 2008.01 학술저널

2007

급성 충수염 진단에서 CT를 이용한 Alvarado Score의 효용 분석

이성민 , 장인택 , 김범규 외 1명 대한외과학회 학술대회 초록집 2007.05 학술대회자료

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Acute appendicitis is the most common cause of an acute abdomen that needs an emergency operation. However, the preoperative diagnosis is difficult. The purpose of this study is to assess the diagnostic efficacy of the Alvarado score by a comparison with CT and to determine the indication of CT evaluation. Methods: From August 2006 to October 2006, 111 consecutive patients were admitted to Chung-Ang University hospital under the impression of acute appendicitis, and a CT scan was done. The Alvarado score, which consists of migration, anorexia, nausea-vomitig, tenderness, rebound tenderness, fever, leukocytosis, and left shift, was applied to the patients. Results: Of the 111 patients, 85 patients underwent an operation, and 26 were discharged without an operation on the basis of the CT finding. The negative appendectomy rate were 4.7%. CT showed a sensitivity, of 0.90 a specificity of 0.97 and an accuracy rate of 0.92. Tenderness and leukocytosis were confirmed as the most important tests and showed accuracy rates of 0.73 and 0.70, respectively. The sensitivity was 0.90 at score 5 and 0.85 at score 7. Therefore, there was no single cut-off score that satisfied all diagnostic values. Conclusions: The Alvarado score alone is not a satisfactory diagnostic method acute appendicitis. Of the appendicitis patients, 90% might be included in the diagnosis for Alvarado scores above 5, and the negative appendectomy could be as high as 15% for Alvarado scores above 7, which is the score generally accepted for a diagnosis of appendicitis.

#급성충수염 #컴퓨터전산화촬영 #Avarado점수제

참고문헌 (14)

참고문헌 신청

Brewer BJ / 1976 / bdominal pain. An analysis of 1,000 consecutive cases in a University Hospital emergency room / Am J Surg 131:219~223

Korner H / 1997 / Incidence of acute nonperforated and perforated appendicitis: age-specific and sex-specific analysis / World J Surg 21:313~317

Terasawa T / 2004 / Systemaic review: computed tomography and ultrasonography to detect acute appendicitis in adults and adolescents / Ann Intern Med 141:537~546

Martin AE / 2004 / CT scans may not reduce the negative appendectomy rate in children / J Pediatr Surg 39:886~890

Choi YW / 1995 / Diagnostic accuracy and complications of acute appendicitis and incidence and complications of negative explorations in 3,303 cases of suspected appendicitis / J Korean Surg Soc 49:268~276