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[重症监护下外科患者胸部检查及尸检结果综述(作者译)]

[A review of the findings on chest examinations and at autopsy in surgical patients under intensive care (author's transl)].

作者信息

Janson R, Thelen M, Rommelsheim K, Louven B, Siege P

出版信息

Rofo. 1976 May;124(5):427-33. doi: 10.1055/s-0029-1230365.

Abstract

The present paper deals with the findings on examination of the chest and at autopsy in 100 selected surgical patients under intensive care; of these 17% were post-traumatic, 55% had post-operative lung complications and in 28% there had been no trauma or previous operations. The accuracy of the radiological diagnosis was checked against the autopsy findings. Pneumonia and pulmonary oedema were the most common lung complications in all three groups, with an incidence of 59 to 82%, and were diagnosed with an accuracy of 92 to 95%. Other conditions which were looked for were pulmonary congestion, emboli and lung infarcts, pleural effusions, atelectasis, pulmonary haemorrhage or contusion and pneumothorax. The most common mis-diagnosis was in the demonstration of emboli and infarcts, where accuracy was only 64%. The difficulties in differential diagnosis of the radiological appearances due to these pulmonary complications are discussed.

摘要

本文论述了对100例接受重症监护的择期手术患者进行胸部检查及尸检的结果;其中17%为创伤后患者,55%有术后肺部并发症,28%既无创伤史也无既往手术史。将放射学诊断的准确性与尸检结果进行了对照。肺炎和肺水肿是所有三组中最常见的肺部并发症,发病率为59%至82%,诊断准确率为92%至95%。还对其他病症进行了检查,包括肺充血、栓子和肺梗死、胸腔积液、肺不张、肺出血或挫伤以及气胸。最常见的误诊发生在栓子和梗死的显示方面,其准确率仅为64%。文中讨论了这些肺部并发症在放射学表现上的鉴别诊断困难。

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