这位病人有多发性溢血吗?
Camilla L Wong1, Jayna Holroyd-Leduc, Sharon E Straus
1Division of Geriatrics, University of Toronto, and St Michael's Hospital, Toronto, Ontario, Canada.
JAMA
|January 22, 2009
概括
身体检查可以帮助诊断肺溢液. 敲击的沉默强烈暗示出血,而缺席的触觉 fremitus 使其不太可能,可能避免不必要的胸部X射线.
科学领域:
- 肺部病理学 肺部病理学
- 诊断的准确性 诊断的准确性
- 临床检查 临床检查
背景情况:
- 胸腔溢液是患有呼吸道症状的患者经常出现的疾病.
- 床边体检的诊断实用性对于腹溢液的诊断仍然不确定.
研究的目的:
- 系统地审查现有证据,以确定身体检查技术的准确性,以评估多发性溢血的可能性.
主要方法:
- 在MEDLINE和EMBASE (1950-2008) 数据库中搜索英语语言的前性诊断准确性研究.
- 包括比较身体检查机动与肺流的放射性确认的研究.
- 提取了关于研究质量,参与者招募,参考标准和诊断测试准确性的数据.
主要成果:
- 五项前性研究 (934名患者) 符合纳入标准.
- 与传统打击乐器相比,沉默表现出最高的准确性 (正概率比:8.7).
- 缺少减少的触觉声声声表明多流的可能性较低 (负概率比:0.21).
结论:
- 敲击和触觉 fremitus 的沉是流的关键物理发现.
- 沉默的打击会增加溢出的可能性,需要进行胸部X射线检查以确认.
- 缺少减少的触觉 fremitus 在低概率的情况下,可能会排除需要进行胸部X射线图的需要.
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