Dawson K P, Steinberg A, Capaldi N
Paediatric Department, Westmead Hospital, NSW, Australia.
J Qual Clin Pract. 1994 Mar;14(1):39-43.
The films of 61 children who had a lateral radiograph of neck performed in the management of acute laryngo-tracheo-bronchitis were reviewed by a paediatric radiologist. He was unaware of the clinical history and the outcome of the children's illnesses. The clinical records of the same children were reviewed independently and information sought about the clinical relevance of the film results. Sixty per cent of the films were felt to be in keeping with a diagnosis of acute laryngo-tracheo-bronchitis. As judged by the information in the medical records these results did not influence the management of the children other than in one instance where a child underwent laryngoscopy. This decision was strongly influenced by the original film report. No child developed acute airway obstruction while in the Radiology Department. The findings of this study support the concept that a request for a lateral X-ray of neck in croup is an inefficient use of diagnostic facilities.
一位儿科放射科医生对61名因急性喉气管支气管炎接受颈部侧位X线检查的儿童的X光片进行了复查。他并不了解这些儿童的临床病史及疾病转归情况。同时，独立复查了这些儿童的临床记录，并收集了X光片检查结果与临床相关性的信息。60%的X光片被认为符合急性喉气管支气管炎的诊断。根据病历中的信息判断，除了1例患儿接受了喉镜检查外，这些检查结果并未对患儿的治疗产生影响，而这一决定很大程度上受到最初X光片报告的影响。在放射科期间，没有患儿发生急性气道梗阻。本研究结果支持这样一种观点，即因喉炎而要求进行颈部侧位X线检查是对诊断设备的低效利用。
