Abstract:
Objective
To screen diadynamic criterium of strangulated intestinal obstruction for raising it’s correct diagnosis rate.
Methods
26 indexes of 652 strangulated intestinal obstruction patients who were treated in our hospital or were reported in documents were admitted to analyze, which included age, sex, bellyache, abdominal distension, nausea, vomitting, aerofluxus and defecation ceased,intestinal shape,tension of abdominal muscles, tenderness,rebounding pain,plain abdominal x-ray,blood gas analysis,CO2CP,blood coagulation function, and etc. We screened the indexes by Meta-analysis according to the three essential elements of Evidence-Based Medicine, which is“investigate evidences,clinical experiences and patient’s requirements”. We further applied these indexes to a certain quantitative strangulated intestinal obstruction cases and simple intestinal obstruction cases to test their practical effect.
Results
Ten diagnostic indexes of strangulated intestinal obstruction were picked out. They were：①unrelieved bellyache or aggravated abdominal distention;②T≥38℃;③P≥100 t/Min;④WBC≥15×109/L;⑤Hb≤90 g/L;⑥abdominal part is dissymmetry,intestinal shape and peristaltic waves; ⑦peritoneal irritation sign; ⑧madder red haematodes abdominal cavity puncture fluid or it shows amber liquid with many red blood cells under microscopic examination; ⑨fixed and expanded aggravately ansa intestinalis under mageological tests; ⑩shock.On the basis of definite ileac, the patients who conformed to two or above indexes could be diagnosed as strangulated intestinal obstruction. According to this diadynamic criteria and method, the correct diagnositic rate of 625 strangulated intestinal obstruction patients was 92%, while none of 604 simple intestinal obstruction patients was diagnosed as strangulated intestinal obstruction.
Conclusion
These diadynamic criterium and methods are especially possessed by strangulated intestinal obstruction and the correct diagnositic rate rises from the past 61%to 92%.They are also simple,convenient and easy to remember.
Key words:
Strangulated intestinal obstruction,
Diadynamic criteria,
Screen,
Meta-analysis
Yun-fu LU, Xin-qiu LI, Xi-ao-guang GONG, Wei-wei HUANG, Yi-jun YANG, Yi-ming CHEN, Qing-an QIU, Bao-chun WANG. Meta-analysis and screening for diadynamic criterias of strangulated intestinal obstruction[J]. Chinese Archives of General Surgery(Electronic Edition), 2008, 02(01): 71-74.