Losek J D, Kishaba R G, Berens R J, Bonadio W A, Wells R G
Medical College of Wisconsin, Department of Radiology, Children's Hospital of Wisconsin, Milwaukee.
Pediatr Emerg Care. 1989 Sep;5(3):149-52. doi: 10.1097/00006565-198909000-00001.
A combined retrospective and prospective analysis of infants 60 days of age or less evaluated for fever (greater than or equal to 38.3 degrees C) or history of fever who received chest roentgenogram over a one-year period was performed to determine whether clinical characteristics were predictive of pneumonia. Of the 209 patients studied, 115 were reviewed prospectively and 94 retrospectively. Pneumonia was radiographically diagnosed in 16 patients. Individual clinical factors were not found to be highly predictive of pneumonia. However, infants with the following nine factors did not have pneumonia; illness in the summer months; absence of cough, dyspnea, and respiratory distress (grunting/flaring/retracting); respiratory rate less than 60; absence of rales and decreased breath sounds; presence of normal color; and white blood cell count less than 19,000/mm3. We recommend that these clinical characteristics be utilized to determine whether chest roentgenogram is warranted in the young infant evaluated for fever.
对60日龄及以下因发热（体温大于或等于38.3摄氏度）或有发热史而接受胸部X光检查的婴儿进行了一项回顾性与前瞻性相结合的分析，以确定临床特征是否可预测肺炎。在研究的209例患者中，115例进行了前瞻性评估，94例进行了回顾性评估。经X光检查确诊16例患有肺炎。未发现个体临床因素对肺炎有高度预测性。然而，具有以下九个因素的婴儿未患肺炎：夏季患病；无咳嗽、呼吸困难及呼吸窘迫（呼噜声/鼻翼扇动/三凹征）；呼吸频率低于60次；无啰音及呼吸音减弱；面色正常；白细胞计数低于19,000/mm³。我们建议利用这些临床特征来确定对因发热接受评估的幼儿是否有必要进行胸部X光检查。
