Rossi O V, Lähde S, Laitinen J, Huhti E
Department of Internal Medicine, University of Oulu, Finland.
Int Arch Allergy Immunol. 1994 Sep;105(1):96-100. doi: 10.1159/000236809.
In order to evaluate the clinical utility of chest and paranasal sinus radiographs on admission in cases of acute asthma, the radiographs of adult patients admitted to our hospital for acute asthma over a period of 1 year were studied. The findings were specified afterwards by a senior diagnostic radiologist and their impact on the management of asthma was evaluated by reviewing the medical records of the patients retrospectively. Abnormalities were detected in 50% of the chest radiographs (55 of 110) and these resulted in management changes in 5% of cases (6 of 100). Abnormalities in any paranasal sinuses were detected in 85% of the sinus radiographs (93 of 100), and maxillary sinus abnormalities in 63% (70 of 100). 29% of the sinus abnormalities (32 of 110) resulted in an immediate alteration in treatment. Hence abnormalities were more common in the paranasal sinus radiographs than in the chest radiographs (p < 0.001), and the impact of the sinus radiographs on the treatment of asthma was also greater (p < 0.001). We recommend that while obtaining a chest radiograph routinely may be advisable in severe cases of acute asthma, at least when the patient is admitted to hospital, serious thought should be given to routinely obtaining a sinus radiograph in these cases as well.
为了评估急性哮喘患者入院时胸部和鼻窦X光片的临床效用，我们对我院1年内因急性哮喘入院的成年患者的X光片进行了研究。之后由一位资深诊断放射科医生明确检查结果，并通过回顾患者病历对这些结果对哮喘治疗的影响进行评估。胸部X光片中50%（110例中的55例）检测到异常，其中5%（100例中的6例）的病例治疗因此改变。鼻窦X光片中85%（100例中的93例）检测到鼻窦异常，上颌窦异常占63%（100例中的70例）。29%的鼻窦异常（110例中的32例）导致治疗立即改变。因此，鼻窦X光片中的异常比胸部X光片中更常见（p<0.001），鼻窦X光片对哮喘治疗的影响也更大（p<0.001）。我们建议，虽然在急性哮喘严重病例中常规拍摄胸部X光片可能是可取的，但至少在患者入院时，也应认真考虑对这些病例常规拍摄鼻窦X光片。
