对肺挫伤患者进行CT单独诊断与其患病率的升高无关

作     者：Kwon A. Sorrells Jr. D.L. Kurkchubasche A.G. F.I. Luks 刘凯 

作者机构：Division of Pediatric SurgeryBrown Medical School ProvidenceRI 02905United States 

出 版 物：《世界核心医学期刊文摘（儿科学分册）》 (Dkgest of the World Latest Medical Information)

年 卷 期：2006年第2卷第5期

页      面：37-37页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：胸部CT检查 肺挫伤 伤患者 诊断 患病率 胸部X线照片 创伤严重度评分 重症监护室 

摘      要：Background: Increased utilization of computed tomography (CT) has led to a rise in the diagnosis of pulmonary contusion. Its clinical significance, in the absence of findings on chest radiograph (CXR), has not been defined. This study examines the clinical course of patients with CT-only diagnosis of pulmonary contusion and compares it with that of patients with CXR-proven pulmonary contusion. Methods: The trauma database identified all children undergoing chest CT for blunt thoracic trauma during a 3-year period. Records were reviewed for age,mechanism of injury, Injury Severity Score (ISS), length of hospital stay (LOS), need for intensive care unit admission, and need for endotracheal intubation. A pedi atric radiologist reviewed all films in a blinded fashion. Statistical analysis was performed using analysis of variance and Fisher’s Exact test for 2 ×3 tables. Results: Eighty-two patients were identified. There were no CXR-positive, CT-negative cases. A CT diagnosis of pulmonary contusion was made in 46 patients. Of these, 31 had a contusion on CXR as well (CXR+group) and 15 had a normal CXR (CT+only group). Mean ISS score did not differ significantly between the two groups (27±12.3 and 22±10.3, respectively). Thirty-six patients had a normal CT (control). Mean LOS was significantly longer in the CXR+group (13±12.0 days) than in the CT+only and control groups (5±3.6 and 9±9.5 days, respectively; P .01). The percentages of children requiring intensive care unit admission and intubation were also significantly higher in the CXR+group. Conclusion: The finding of pulmonary contusion by CT alone does not increase patient morbidity and appears to be of limited clinical significance.