触诊与B超法诊断甲状腺肿大的差异及原因分析

目的：了解触诊与B超法诊断甲肿的差异及其原因。方法：采用人口比较概率抽样法对贵州省30个县的1200名8－10名小学生用触诊法和B超法同时进行检查。结果：8岁组B超法肿大率显著高于触诊法（P＜0．01），10岁组触诊法肿大率高于B超法，差异接近显著（P＝0．0599），以B超法为金标准，触诊法的灵敏度为58．62％，漏诊率为41．38％，特异度89．57％，误诊率为10．40％（101／968），触诊法与B超法一致率为83．58％。结论：甲状腺肿的检出以B超法为准，触诊法漏诊率偏高，导致误差的主要原因来自触诊检查者诸多主观因素的影响。

Analysis of the difference between palpation and ultrasonic method on diagnosing goiter

Objective In order to explore the difference and its reason between palpation method and ultrasonic methods on diagnosing goiter.Methods Tweleve hundred pupils of 8 to 10 age groups from 30 counties of GUIZHOU province were sampled by PPS method, and their thyroids were examined by palpation method and ultrasonic method at the same time.Results The goiter rate by ultrasonic method was significantly higher (P<0.01) among 8 age group ,and was nearly significantly lower (P=0.0599)among 10 age group than that by palpation method .With the use of ultrasonic as the gold standard of diagnosing goiter, the sensitivity, by palpation method, was 58.62%, the false negative rate was 41.38%, the specificity was 89.57%,and the false positive rate was 10.40% .The agreement rate was 83.58% between ultrasonic and palpation methods.Conclusions With ultrasonic as the gold standard, the false negative rate of palpation method was getting a bit high to diagnose goiter .The main reason causing the difference between palpation and ultrasonic method was the subjective factors from examiner of palpation.