医学诊断专家系统在胆总管结石预测中的作用
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钟立明 E-mail:super_lican@163.com

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广东省深圳市科技计划资助项目 (JH200505300482B)。


Application of medical diagnosis expert system in predicting common bile duct stones
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    摘要:

    目的:探讨医学诊断专家系统结合术前磁共振胰胆管显像(MRCP)预测胆总管结石的可行性及其应用价值。
    方法:对5个月内因胆囊结石、胆囊炎入院的286例患者进行前瞻性研究。随机分为研究组和对照组,每组143例。对照组术前常规接受MRCP检查。研究组先利用基于人工神经网络(ANN)构建的、运行稳定的医学诊断专家系统进行筛查,筛查阳性者再行MRCP检查。比较两组患者的MRCP阳性率、平均住院时间及平均住院费用。
    结果:对照组胆总管结石阳性率为16.78% (24/143),研究组胆总管结石阳性率为16.08% (23/143)。但研究组MRCP检查阳性率为95.24%(20/21),明显高于对照组的14.69%(21/143)(P<0.01)。研究组平均住院时间为(8.83±3.59)d,明显短于对照组的(10.10±3.66) d (P<0.01),研究组平均住院费用为(11 175.80±7 972.33)元,明显低于对照组的(13 332.08±9 884.04)元(P<0.05)。
    结论:医学诊断专家系统对胆总管结石有良好的预测作用;它可作为一种常规初筛手段选择合适病例行MRCP检查,可显著缩短住院时间和降低住院费用。

    Abstract:

    Objective: To evaluate the feasibility and the efficacy of medical diagnosis expert system, combined with preoperative magnetic resonance cholangiopancrcatography(MRCP), in predicting common bile duct(CBD) stones. 
    Methods: The clinical data of 286 cases of cholecystolithiasis and cholecystitis admitted to our hospital during Jan 2009 to May 2009 were analysed prospectively. These cases were divided randomly into the control group (n=143) and the research group (n=143). The control group underwent routine MRCP before cholecystectomy, while the research group was screened by medical diagnosis expert system which had been established based on artificial neural network technique and proved to be stable. MRCP was performed in every patient of the research group when the screening result was positive. Then, the positive rate of MRCP, the mean hospitalization time and the average expenditure between this two groups were compared.
    Results: CBD positive rate was 16.78%(24/143) of the control group, while the research group was 16.08% (23/143). The positive rate of MRCP of the research group was 95.24%(20/21),significantly higher than 14.69%(21/143)of the control group(P<0.01). The mean hospitalization time of research group (8.83±3.59 d) was significantly shorter than that of the control group (10.10±3.66 d)  (P<0.01).The average expenditure of the research group was (11 175.80±7 972.33) Yuan, evidently lower than (13 332.08±9 884.04) Yuan of the control group (P<0.05). 
    Conclusions: The medical diagnosis expert system has a remarkable performance in predicting CBD stones. It can be used routinely to select the appropriate cases to undergo MRCP, which could obviously reduce the hospitalization costs and shorten the hospitalization time.

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黎灿强| 钟立明| 韩月锋|彭毅|叶建宇.医学诊断专家系统在胆总管结石预测中的作用[J].中国普通外科杂志,2010,19(8):861-865.
DOI:10.7659/j. issn.1005-6947.2010.08.007

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  • 收稿日期:2009-07-03
  • 最后修改日期:2010-02-24
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  • 在线发布日期: 2010-08-15