概括
入院胸部X射线很少改变患者的治疗,特别是在没有症状的患者中. 常规的胸部X射线 (CXRs) 可以减少60%而不会影响患者的护理.
科学领域:
- 医疗成像医学成像
- 临床管理 临床管理
- 诊断的准确性 诊断的准确性
背景情况:
- 入院胸部X射线 (CXR) 经常在一般医疗病房中使用.
- 在所有入院患者中,常规CXR的临床影响和必要性仍然是调查对象.
研究的目的:
- 为了前性地评估入院胸部X射线对一般医疗病房入院患者临床管理的独立影响.
- 确定CXRs在改变患者诊断,调查和治疗计划中的收益率.
主要方法:
- 对连续432次通用医疗病房入院的前性评估.
- 临床数据,包括诊断,调查和治疗,在CXR之前仅根据临床发现进行记录.
- 根据患者表现和CXR发现,记录和分析了CXR后管理的变化.
主要成果:
- 在432名患者中,有226人 (53%) 患有异常CXR,但只有9%的CXR导致了管理的改变.
- 在没有心肺呼吸系统疾病症状的患者中 (n=214),CXRs改变了5%的治疗方法,并使1.4%受益.
- 治疗方法的改变在患有新的心肺呼吸系统疾病 (14%) 和可能患有胸部疾病 (9%) 的患者中是最高的.
结论:
- 在没有临床证据表明胸部疾病的患者中,常规的入院胸部X射线提供了最小的临床益处.
- 选择性使用CXRs在有明确指示的患者可以减少约60%的检查数量.
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