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对于心血管手术患者的每日胸部X射线:强制性还是神话?
Jonathan Gale1, Gurmeet Singh2
1Department of Critical Care Medicine, Dalhousie University, Halifax, Canada.
Seminars in thoracic and cardiovascular surgery
|October 31, 2025
概括
常规的每日胸部X射线 (CXRs) 在重症监护室缺乏临床实用性. 按需的CXR策略提供了可比的安全性,减少了辐射暴露,并且在没有不利结果的情况下节省了成本.
科学领域:
- 关键护理医学 关键护理医学
- 放射学 放射学是一门学科.
- 胸部外科手术 胸部外科手术
背景情况:
- 常规的每日胸部放射 (CXR) 是重症监护室 (ICU) 的标准,用于术后监测.
- 有证据表明,常规CXR具有较低的诊断和治疗效用.
- 这种做法导致不必要的辐射暴露和医疗保健费用.
研究的目的:
- 评估常规胸部X射线相对于在ICU的需求胸部X射线的临床实用性.
- 为了比较两种策略之间的患者安全,辐射暴露和成本.
- 为心胸外科手术患者进行术后成像的基于证据的指导方针提供信息.
主要方法:
- 对现有常规与按需CXR策略的现有证据进行系统审查.
- 对诊断产量,治疗影响和患者结果的分析.
- 评估成本效益和辐射暴露.
主要成果:
- 按需CXR策略提供了与常规CXR相比的患者安全性.
- 按需的CXR显著降低了辐射暴露和医疗保健成本.
- 常规CXR很少在心胸外科手术后的患者中发现需要干预的重大并发症.
结论:
- 从例行到按需CXR的过渡是基于证据的,符合高价值护理原则.
- 根据临床指示指导的按需成像是一种安全且具有成本效益的替代方案.
- 临床症状和症状是订购CXRs的可靠指标,即使在像胸管切除等手术后也是如此.
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