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对转诊至三级医疗兽医医院治疗非心肺疾病的犬猫进行胸部X光片筛查试验的评估。

Evaluation of thoracic radiographs as a screening test for dogs and cats admitted to a tertiary-care veterinary hospital for noncardiopulmonary disease.

作者信息

Keyserling Christine L, Buriko Yekaterina, Lyons Bridget M, Drobatz Kenneth J, Fischetti Anthony J

机构信息

Emergency and Critical Care, The Animal Medical Center, New York, NY, 10065.

Department of Emergency and Critical Care, University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA, 19104.

出版信息

Vet Radiol Ultrasound. 2017 Sep;58(5):503-511. doi: 10.1111/vru.12519. Epub 2017 Jun 22.

Abstract

Thoracic radiographs are used as a screening tool for dogs and cats with a variety of disorders that have no clinical signs associated with thoracic structures. However, this practice has never been supported by an evidence-based study. The objective of this retrospective observational study was to determine if certain canine and feline populations have a higher proportion of radiographic abnormalities, and whether any of these abnormalities are associated with patient hospitalization and outcome. Patients were excluded if current or previous examinations revealed evidence of primary respiratory or cardiac disease, malignant neoplasia, or an abnormal breathing pattern consistent with pulmonary pathology. Any notable thoracic change in the radiology report was considered important and evaluated in this study. One hundred and sixty-six of these included patients were dogs and 65 were cats. Of the 166 dog radiographs evaluated, 120 (72.3%) had normal thoracic radiographs, while 46 (27.7%) had radiographic abnormalities. Of the sixty-five cats included, 36 (55.4%) had normal radiographs, while 29 (44.6%) had abnormal radiographs. Canine patients with abnormal radiographs had a significantly higher lactate level (P-value 0.0348) and feline patients with abnormal radiographs had a significantly lower packed cell volume (P-value 0.012). A large proportion of patients that had screening thoracic radiographs (32.5%) had documented abnormalities, but a relatively low percentage (6.5%) of our total population had their clinical plan changed as a consequence of detection of these abnormalities. Findings indicated that abnormal screening thoracic radiographs are more likely in dogs with an elevated lactate and cats with anemia, or a low normal hematocrit.

摘要

胸部X光片被用作患有各种疾病但无胸部结构相关临床症状的犬猫的筛查工具。然而,这种做法从未得到过循证研究的支持。这项回顾性观察研究的目的是确定某些犬猫群体的X光片异常比例是否更高,以及这些异常是否与患者住院情况和预后相关。如果当前或既往检查显示有原发性呼吸道或心脏疾病、恶性肿瘤或与肺部病理一致的异常呼吸模式的证据,则将患者排除。放射学报告中任何显著的胸部变化都被视为重要变化并在本研究中进行评估。这些纳入的患者中,166只为犬,65只为猫。在评估的166张犬X光片中,120张(72.3%)胸部X光片正常,而46张(27.7%)有X光片异常。在纳入的65只猫中,36只(55.4%)X光片正常,而29只(44.6%)有异常X光片。X光片异常的犬患者乳酸水平显著更高(P值0.0348),X光片异常的猫患者红细胞压积显著更低(P值0.012)。进行胸部X光片筛查的患者中有很大比例(32.5%)记录有异常,但在我们的总体患者中,因检测到这些异常而改变临床治疗计划的比例相对较低(6.5%)。研究结果表明,乳酸水平升高的犬和贫血或血细胞比容略低于正常水平的猫更有可能出现异常的胸部筛查X光片。

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