胸部计算机断层扫描是否应该在被转诊为主要紧急腹部病理的腹部计算机断层扫描的患者中成为常规:一项探索性临床研究
Jannick Brander Hansen1,2,3, Lasse Lykkebo Hald4,5, Nicolas Storm1
1Department of Gastrointestinal and Hepatic Diseases, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.
将全胸部计算机断层扫描 (CT) 扫描添加到紧急腹部CT中,为腹部疼痛患者提供了更多的诊断信息. 这种扩展的CT协议确定了更重要的发现,如肺炎,而不会影响死亡率.
科学领域:
- 放射学 放射学是一门学科.
- 紧急医疗 紧急医疗
- 手术病理学手术病理学
背景情况:
- 优化的护理包已改善了紧急主要腹部手术的结果.
- 通过腹部计算机断层扫描 (CT) 和及时手术进行快速诊断至关重要.
- 在出现腹部疼痛的患者中,诊断的挑战仍然存在.
研究的目的:
- 评估添加对比度增强的胸部CT到腹部CT是否提供了重要的诊断信息.
- 评估扩展CT协议对患者管理和结果的影响.
主要方法:
- 追溯队列研究,将接受扩展CT (腹部+胸部) 的患者与接受标准腹部CT的历史队列进行比较.
- 纳入标准:怀疑主要腹部病理的患者.
- 主要结局:胸部CT结果导致在索引入院期间进行治疗或干预.
主要成果:
- 扩展CT组 (187名患者) 与标准组 (5.3%) 相比,显示出显著更多临床显著的胸部发现 (15.0%).
- 在扩展CT组中,肺炎的诊断频率更高 (18例对3例).
- 虽然扩展CT更常见的可疑发现,但它并没有导致门诊转诊的显著增加.
结论:
- 包括全胸部CT在内的扩展CT协议在怀疑主要腹部病理时提供额外的诊断价值.
- 这种增强的成像方法可以识别关键的胸部疾病以及腹部问题.
- 扩展协议提供了有价值的信息,但不会对死亡率产生负面影响.
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