Mahabee-Gittens E M, Bachman D T, Shapiro E D, Dowd M D
Division of Emergency Medicine, Children's Hospital Medical Center, Cincinnati, Ohio 45229-2899, USA.
Clin Pediatr (Phila). 1999 Jul;38(7):395-9. doi: 10.1177/000992289903800703.
There are no widely accepted predictors of pneumonia in wheezing infants and toddlers who present to the emergency department (ED). A 10-month retrospective review of ED visits of wheezing children < or = 18 months of age revealed the following chest radiograph (CXR) results: normal (21%), findings consistent with uncomplicated bronchiolitis or asthma (61%), focal infiltrates (18%), and other abnormalities (< 1%). Patients with focal infiltrates on CXR were more likely to have the following: a history of fever (p = 0.03, OR 2.1, 95% CI 1.0, 4.4), temperature > or = 38.4 degrees (p = 0.01, OR 2.5, 95% CI 1.1, 5.8) or crackles on examination (p < 0.0005, OR 3.9, 95% CI 1.7, 9.0). Selective use of CXRs has the potential to save health care dollars and limit unnecessary radiation.
对于前往急诊科（ED）就诊的喘息婴幼儿，目前尚无广泛认可的肺炎预测指标。一项针对18个月及以下喘息儿童的急诊科就诊情况进行的为期10个月的回顾性研究显示，胸部X光（CXR）检查结果如下：正常（21%）、符合单纯性细支气管炎或哮喘的表现（61%）、局灶性浸润（18%）以及其他异常情况（<1%）。胸部X光显示有局灶性浸润的患者更有可能出现以下情况：发热史（p = 0.03，比值比2.1，95%置信区间1.0，4.4）、体温≥38.4摄氏度（p = 0.01，比值比2.5，95%置信区间1.1，5.8）或检查时有啰音（p < 0.0005，比值比3.9，95%置信区间1.7，9.0）。选择性使用胸部X光检查有节省医疗费用和减少不必要辐射的潜力。
