远程医疗和使用胸部X射线治疗小儿社区肺炎:从COVID-19封锁中吸取教训
Sophia Eilat-Tsanani1,2, Moti Almog1,3, Vered Levy1,2
1Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
Telemedicine reports
|December 4, 2025
概括
在COVID-19封锁期间,远程医疗的使用激增,但对于儿科社区获得性肺炎 (CAP) 的胸部X射线使用仍然稳定. 这表明远程医疗可以支持肺炎儿童的审慎诊断成像.
科学领域:
- 儿科 儿科 儿科
- 传染性疾病 传染性疾病
- 医疗保健服务研究 医疗服务研究
背景情况:
- 社区获得性肺炎 (CAP) 是一个重要的儿童疾病,指导方针优先考虑临床评估而不是常规成像.
- 随着COVID-19大流行,远程医疗在医疗机构的采用迅速推进.
- 越来越多的远程医疗对儿科CAP的诊断和管理的影响需要研究.
研究的目的:
- 评估COVID-19封锁期对儿童CAP诊断的胸部X射线利用在初级保健中的影响.
- 为了比较疫情封锁期间的成像趋势与疫情前的时期.
- 在不同医疗保健环境中确定影响儿科CAP诊断成像决策的因素.
主要方法:
- 追溯数据库研究分析1-14岁儿童被诊断患有CAP.
- 将三个封锁时期 (2020-2021) 的数据与相应的疫情前时期 (2018-2019) 的数据进行比较.
- 分析远程咨询率,胸部X射线转诊率和抗生素处方模式.
主要成果:
- 在封锁期间,远程咨询从1.7%大幅增加到11.6% (p < 0.001).
- 胸部X射线转诊和用于儿科CAP的抗生素使用在疫情前和封锁期间保持一致.
- 影像成像的预测因素发生了变化,社会经济地位在封锁期间成为一个重要因素,取代了年龄和旅行距离.
结论:
- 远程医疗的采用并没有导致在封锁期间为儿科CAP增加胸部X射线的使用.
- 尽管远程咨询的增加,但临床判断和成像的既定指导方针似乎仍然存在.
- 未来的战略可以利用远程医疗来提高诊断信心,并促进儿童肺炎护理中的"明智选择"原则.
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