腹部的平面膜仍然是A&E的低灵敏度测试
Daniel P McKenna1, Morgan P McMonagle2
1Department of Surgery, University Hospital Waterford, Dunmore Road, Waterford, X91 ER8E, UK. danielmckenna21@rcsi.com.
Irish journal of medical science
|June 20, 2023
概括
平面膜腹部X射线在急诊室被过度使用,并且往往无法检测出严重的疾病. 这些腹部成像研究提供了最小的临床价值,不应该指导患者的护理决策.
科学领域:
- 放射学 放射学是一门学科.
- 紧急医疗 紧急医疗
- 诊断成像 诊断成像 诊断成像
背景情况:
- 平面膜腹部 (PFAs) 常用于急诊室,用于腹部症状患者.
- 然而,PFA的灵敏度和特异性较低,对临床决策做出最小的贡献.
- 人们质疑PFAs对紧急情况下患者管理的实用性和影响.
研究的目的:
- 为了研究平面膜腹部在急诊室环境中的利用和诊断产量.
- 为了测试PFAs被过度利用的假设,为临床医生和患者提供虚假的保证.
主要方法:
- 在爱尔兰的第三级转诊医院,应急部门要求对PFA进行了回顾性审查.
- 分析了2022年1月1日至2022年8月31日期间国家综合医学成像系统 (NIMIS) 的数据.
- 涉嫌异物体的病例被排除在外,随后的成像被审查以求相关性.
主要成果:
- 总共分析了619个PFA,其中57%没有显示异常.
- 只有15%的PFA发现与随后的成像结果相关.
- 像破裂的大动脉动脉瘤和穿孔等关键发现被PFAs遗漏,但在CT扫描上被检测出来.
结论:
- 平面膜腹部放射学在急诊室被过度使用.
- 然而,PFA缺乏有效检测急性病理的灵敏度.
- 使用PFA不应影响有关进一步成像或全面临床评估的决定.
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