Swensen S J, Peters S G, LeRoy A J, Gay P C, Sykes M W, Trastek V F
Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN 55905.
Mayo Clin Proc. 1991 Apr;66(4):396-410. doi: 10.1016/s0025-6196(12)60665-x.
Portable chest radiography is an essential component of clinical patient management in the intensive-care unit. With routine use of this procedure, unexpected cardiopulmonary abnormalities are frequently detected, and malposition or complications of intravascular devices and endotracheal, thoracostomy, or nasogastric tubes are also commonly found. The pulmonary parenchyma may be assessed for changes of acute lung injury, cardiogenic edema, areas of pneumonitis, atelectasis, or other abnormal collections of fluid or air. In mechanically ventilated patients, barotrauma occurs frequently and may be manifested by subtle intrathoracic collections of air. Technical factors may limit the resolution of the anteroposterior chest radiograph obtained at the bedside, but crucial clinical information is often gained. Portable chest radiographic findings, the role of computed tomography and ultrasonography, and interventional radiologic procedures pertinent to patients in the intensive-care unit are reviewed.
便携式胸部X线摄影是重症监护病房临床患者管理的重要组成部分。通过常规使用该检查方法，常可发现意外的心肺异常，血管内装置以及气管内、胸腔造口或鼻胃管的位置不当或并发症也很常见。可评估肺实质有无急性肺损伤、心源性水肿、肺炎区域、肺不张或其他异常的液体或气体积聚。在机械通气的患者中，气压伤很常见，可能表现为胸腔内少量积气。技术因素可能会限制床旁前后位胸部X线片的分辨率，但通常能获取关键的临床信息。本文综述了便携式胸部X线摄影的表现、计算机断层扫描和超声检查的作用以及与重症监护病房患者相关的介入放射学检查方法。
