医学影像学杂志

目的 探讨多层螺旋CT(MSCT)及胸部X线摄影对急诊危重患者肺炎的诊断价值。方法 选取高度疑似肺炎的危重患者145例，患者入院后均接受床旁胸部X线摄影、MSCT检查，以临床诊断为金标准，探讨MSCT、胸部X线摄影对急诊危重患者肺炎的诊断价值。结果 经临床诊断，最终确诊肺炎126例（86.90%）。MSCT、床旁胸部X线摄影诊断急诊肺炎与金标准的一致性分别为0.873、0.692, MSCT诊断一致性较高。MSCT诊断急诊肺炎的灵敏度、准确度较胸部X线摄影高，差异有统计学意义（P<0.05）。两组诊断特异度比较，差异无统计学意义（P>0.05）。经MSCT诊断，126例急诊肺炎患者中，大叶性肺炎45例（35.71%），小叶性肺炎38例（30.16%），间质性肺炎42例（33.33%），无异常改变1例（0.80%）。结论 相较于胸部X线摄影，MSCT诊断急诊危重患者肺炎的价值较高，且其可诊断急诊肺炎具体类型，为临床诊疗方案制定提供帮助。

Objective To explore the diagnostic value of multisliecs helieal CT( MSCT) and chest X-ray photography in the diagnosis of pneumonia in emergency critically ill patients. Methods Critically ill patients with highly suspected pneumonia who visited the emergency department of the hospital were selected as the research objects. All patients received bedside chest Xray photography and MSCT examination after admission, with clinical diagnosis as the gold standard. The diagnostic value of MSCT and chest X-ray for emergency pneumonia was explored. Results After clinical diagnosis, out of 145 suspected pneumonia patients, 126(86.90%) were ultimately diagnosed with pneumonia. The consistency between MSCT and bedside chest X-ray photography in diagnosing emergency pneumonia and the gold standard was 0.873 and 0.692, respectively. The consistency of MSCT diagnosis was relatively high. The sensitivity and accuracy of MSCT in diagnosing emergency pneumonia were higher than those of chest X-ray photography, and the difference was statistically significant(P<0.05). There was no statistically significant difference in diagnostic specificity between the two groups(P>0.05). According to MSCT diagnosis, among 126 emergency pneumonia patients, there were 45 cases(35.71%) of lobar pneumonia, 38 cases(30.16%) of lobular pneumonia, 42 cases(33.33%) of interstitial pneumonia, and 1 case(0.80%) with no abnormal changes. Conclusion Compared with chest X-ray photography, MSCT has a higher value in the diagnosis of pneumonia in critically ill patients in emergency department, which can diagnose the specific types of emergency pneumonia and provide help for the formulation of clinical diagnosis and treatment programs.