重症监护患者床边胸部影像学对肺部疾病的鉴别诊断与随访

B Wallner, A Reszt
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引用次数: 0

摘要

本文回顾了105例重症监护室患者的胸部x线片,探讨其在鉴别诊断和控制肺功能障碍过程中的价值。胸片上可见浸润的时间进程是鉴别诊断最有帮助的标准。肺挫伤和吸入性肺炎在最初的最大值后逐渐下降,肺炎和ARDS在几天内发展到最大浸润。肺血管外水升高呈现多种快速变化的模式。胸膜积液,浸润的外观和定位在鉴别诊断中价值较低。与临床和记忆特征的联系是重要的。放射可见浸润时间与人工呼吸强度有良好的相关性。
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[Differential diagnosis and follow-up of pulmonary disorders by bedside thoracic imaging of intensive care patients].

In this study chest radiographs of 105 patients from an intensive care unit are reviewed to investigate the value in differential diagnosis and control of the course of pulmonary dysfunction. The most helpful criterion in differential diagnosis was the time course of the visible infiltrate on the chest film. Contusion of the lung and aspiration pneumonia showed a steady decrease after an initial maximum, pneumonia and ARDS developed within several days to a maximal infiltration. A rise in extravascular lung water presents with various quickly changing patterns. Pleural effusion, appearance and localisation of the infiltrate are of less value in differential diagnosis. The connection to clinical and anamnestic features is important. There was a good correlation between time course of the radiological visible infiltrate and the intensity of artificial respiration.

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