在ED的阴性胸部X射线图后,随后肺炎的风险
Alexander W Hirsch1,2, Ariella Wagner3, Susan C Lipsett1,2
1Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
Pediatrics
|April 6, 2025
概括
在正常的胸部X射线 (CXR) 后发展放射性肺炎在儿科急诊室并不常见. 临床医生通常可以信任CXR结果来排除肺炎,但应对表现出特定症状的儿童保持谨慎.
科学领域:
- 儿科急救医学 儿科急救医学
- 放射学 放射学是一门学科.
- 传染性疾病 传染性疾病
背景情况:
- 胸部放射 (CXR) 是诊断肺炎的常见工具.
- 有关与临床症状相关的放射性发现的时间存在担忧.
- 在儿科肺炎中CXR的诊断可靠性需要进一步研究.
研究的目的:
- 为了确定放射性肺炎的发病率在儿童最初正常的CXR.
- 为了确定儿童患者的特征,在初始CXR阴性后发展为肺炎.
主要方法:
- 在儿童急诊部进行了10年的回顾性队列研究.
- 包括怀疑肺炎的21岁以下儿童,正常的初始CXR和14天内的后续CXR.
- 排除患有慢性疾病或ICU入院的儿童.
主要成果:
- 在9957名疑似肺炎且初始CXR正常的儿童中,240名在14天内进行了随访CXR.
- 放射性肺炎发生在27名儿童中 (11%的第二次CXR患者).
- 停呼吸,缺氧和脱水被确定为发展放射性肺炎的预测因素.
结论:
- 在正常的CXR之后,放射性肺炎的发生在急诊室环境中并不常见.
- 在ED中,CXR是排除肺炎的可靠工具.
- 建议在出现特定临床特征的儿童中提高临床谨慎性,例如短呼吸,低氧化或脱水.
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