Bekemeyer W B, Crapo R O, Calhoon S, Cannon C Y, Clayton P D
Chest. 1985 Nov;88(5):691-6. doi: 10.1378/chest.88.5.691.
A prospective study of chest radiographic examinations in a respiratory intensive care unit was conducted to determine the diagnostic and therapeutic efficacy of such examinations. Analysis of data from 1,354 x-ray films from 167 patients revealed a 34.5 percent incidence of new (or increased) abnormalities, or tube or catheter malposition. Changes in diagnostic approach or therapeutic measures, excluding catheter position adjustments, occurred after 28.5 percent of the examinations. Radiographic yield was higher when a change in clinical condition prompted the radiographic examination than when the examination was a routine morning study. Changes in the approach to patient management were also more likely (42.7 percent) following examinations that were prompted by a change in a patient's clinical status. Less than 6 percent of the radiographic films taken post-procedure demonstrated abnormalities potentially related to the procedure. We conclude that, in a respiratory intensive care unit: routine morning radiographic examination frequently demonstrates unexpected or changing abnormalities, many of which prompt changes in diagnosis or management radiographic evaluation of a change in a patient's clinical condition has a higher yield than routine examinations; and post-procedure radiographic examination uncommonly demonstrates complications related to the procedure, but frequently demonstrates abnormalities of tube or catheter placement.
为了确定胸部X光检查的诊断和治疗效果，在一家呼吸重症监护病房进行了一项前瞻性研究。对167例患者的1354张X光片数据进行分析后发现，新出现（或加重）的异常、导管或插管位置不当的发生率为34.5%。在28.5%的检查后，除了调整导管位置外，诊断方法或治疗措施发生了改变。当临床状况的变化促使进行X光检查时，X光检查的阳性率高于常规晨间检查。与因患者临床状况变化而进行的检查相比，因患者临床状况变化而促使进行的检查后，患者管理方法的改变也更有可能（42.7%）。术后拍摄的X光片中，不到6%显示出可能与手术相关的异常。我们得出结论，在呼吸重症监护病房：常规晨间X光检查经常显示出意外或变化的异常，其中许多异常促使诊断或管理发生改变；对患者临床状况变化进行的X光评估比常规检查有更高的阳性率；术后X光检查很少显示与手术相关的并发症，但经常显示导管或插管位置异常。
