Use of abdominal percussion for pneumoperitoneum detection.
Use of abdominal percussion for pneumoperitoneum detection.
复制标题
使用腹部叩击进行气腹检测。
DOI：
10.1007/bf02345077
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发表时间：
2002
影响因子：
3.2
通讯作者：
Sandler,RH
中科院分区：
文献类型：
--
作者：
Mansy,HA;Royston,TJ;Sandler,RH
气腹是指腹腔内的自由空气，通常意味着严重的腹部病理，如肠穿孔。该研究的主要假设是，由于气腹引起的腹部结构改变导致腹部叩诊引起的声音的诊断变化。当前的初步研究在杂种犬模型中研究了这些变化。在基线和建立气腹状态后进行腹部叩诊。所产生的声学事件被采集、数字化和分析。事件发作和衰减率以及衰减期间的主频率随着气腹而降低（分别为p=0.084、0.014和0.004; Wilcoxon符号秩检验）。建立了简单的理论模型，并预测了所观察到的谐振频率随气穴尺寸的增加而降低。结果表明，正常和1000 ml气腹状态可以使用发作和衰减率以及共振频率的阈值来区分（特异性分别为80%、100%和100%，灵敏度分别为− 100%、100%和100%）。分离对照组和500 ml气腹组病例也是可能的（特异性分别为80%、100%、100%，灵敏度分别为50%、70%和90%），但使用当前方法分离两个水平的气腹是不可行的。因此，腹部叩诊音的分析可能被证明是有用的气腹检测，但不能区分不同级别的条件。
Pneumoperitoneum refers to free air within the abdominal cavity that typically signifies serious abdominal pathology such as a perforated gut. The principal hypothesis of the study was that abdominal structure alterations due to pneumoperitoneum cause diagnostic changes in the sounds induced by abdominal percussion. The current pilot study investigated these changes in a mongrel dog model. Abdominal percussion was performed at baseline and after creation of pneumoperitoneum states. The resulting acoustic events were acquired, digitised and analysed. The event attack and decay rates and dominant frequencies during decay decreased with pneumoperitoneum (p=0.084, 0.014 and 0.004, respectively; Wilcoxon signed-rank test). Simple theoretical models were constructed and predicted the observed decrease in resonant frequencies with increasing air pocket size. The results suggested that the normal and the 1000 ml pneumoperitoneum states can be separated using thresholds of the attack and decay rates and resonant frequency (specificity = 80%, 100% and 100% and sensitivity−100%, 100% and 100%, respectively). Separating the control and the 500 ml pneumoperitoneum cases may be also possible (specificity = 80%, 100%, 100% and sensitivity = 50%, 70% and 90%, respectively), but separating the two levels of pneumoperitoneum was not feasible using the current approach. Therefore analysis of abdominal percussion sounds may prove useful for pneumoperitoneum detection, but not for distinguishing different levels of that condition.