中国全科医学2012，Vol.15Issue(22)：2541-2543,3.DOI:10.3969/j.issn.1007-9572.2012.08.018
术前超声检查预测急性胆囊炎腹腔镜手术难度的受试者工作特征曲线分析
Evaluation of Ultrasonic Predicting Difficulty of Laparoscopic Cholecystectomy in Acute Cholecystitis by Receiver Operator Characteristic Curve
摘要
Abstract
Objective To explore the predictive value of ultrasonic appearance for difficulty of laparoscopic cholecystectomy ( LC ) in acute cholecystitis. Methods A total of 235 patients with acute cholecystitis received ultrasonic examination before LC. The parameters were measured pre - operation including the volume of gallbladder, cholecystic wall thickness, gallbladder fossa fluid, stone incarceration and adhesion of gallbladder or Calot's triangle. The risk factors associated with difficult LC was selected by Chi - square test, then multivariable analysis with Logistic regression was performed for the selected risk factors and given scores which formed a scoring system for ultrasonic appearance in acute cholecystitis, predicting technical difficulties during LC. Receiver operator characteristic ( ROC ) curve was then applied to analyze the scoring system. Results Multivari-ate analysis showed that enlarged gallbladder, cholecystic wall thickness, stone incarceration in cholecystic neck and adhesion of Calot's triangle were independent risk factors for difficulties during LC. A scoring system for predicting the difficulty level of LC in patients with acute cholecystitis was then established. The ROC curve analysis revealed that area under the curve ( AUC ) was 0. 945, which was statistically higher than 0. 5, the AUC from randomizing scheme ( P <0. 05 ). Conclusion Preoperative ul-trasonography in patients with acute cholecystitis is a good predictor of difficulty in LC, and has an important significance for selection of laparoscopic operation in acute cholecystitis.关键词
腹腔镜胆囊切除术/急性胆囊炎/难度/超声检查/受试者工作特征曲线Key words
Laparoscopic cholecystectomy/ Acute cholecystitis/ Difficulty/ Ultrasonography/ Receiver operator characteristic curve分类
医药卫生引用本文复制引用
赵鲁文,赵洪涛,于爱军,史华宁,张学军,刘金龙..术前超声检查预测急性胆囊炎腹腔镜手术难度的受试者工作特征曲线分析[J].中国全科医学,2012,15(22):2541-2543,3.基金项目
河北省承德市科学技术研究与发展指导计划项目(201121128) （201121128）
