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首页> 外文期刊>The Annals of Thoracic Surgery: Official Journal of the Society of Thoracic Surgeons and the Southern Thoracic Surgical Association >Chest Computed Tomography for Penetrating Thoracic Trauma After Normal Screening Chest Roentgenogram
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Chest Computed Tomography for Penetrating Thoracic Trauma After Normal Screening Chest Roentgenogram

机译：胸部胸部X光检查正常后的胸部计算机断层扫描术

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摘要

Chest computed tomography (CCT) is a method of screening for intrathoracic injuries in hemodynamically stable patients with penetrating thoracic trauma. The objective of this study was to examine the changes in utilization of CCT over time and evaluate its contribution to guiding therapeutic intervention.MethodsA level 1 trauma center registry was queried between 2006 and 2011. Patients undergoing CCT in the emergency department after penetrating thoracic trauma as well as patients undergoing thoracic operations for penetrating thoracic trauma were identified. Patient demographics, operative indications, use of CCT, injuries, and hospital admissions were analyzed.ResultsIn all, 617 patients had CCTs performed, of whom 61.1% (371 of 617) had a normal screening plain chest radiograph (CXR). In 14.0% (51 of 371) of these cases, the CCT revealed findings not detected on screening CXR. The majority of these injuries were occult pneumothoraces or hemothoraces (84.3%; 43 of 51), of which 27 (62.8%) underwent tube thoracostomy. In only 0.5% (2 of 371), did the results of CCT alone lead to an operative indication: exploration for hemopericardium. The use of CCT in our patients significantly increased overall (28.8% to 71.4%) as well as after a normal screening CXR (23.3% to 74.6%) over the study period.ConclusionsThe use of CCT for penetrating thoracic trauma increased 3.5-fold during the study period with a concurrent increase in findings of uncertain clinical significance. Patients with a normal screening CXR should be triaged with 3-hour delayed CXR, serial physical examinations, and focused assessment with sonography for trauma; and CCT should only be used selectively as a diagnostic modality.CTSNet classification:5The use of chest computed tomography (CCT) based on mechanism of injury, without physical findings suggestive of thoracic injury or with a negative initial plain chest radiograph (CXR), has become commonplace in patients with blunt trauma [
机译：胸部计算机断层扫描（CCT）是筛查穿透性胸外血流动力学稳定的患者胸腔内损伤的方法。这项研究的目的是研究CCT使用率随时间的变化，并评估其在指导治疗干预中的作用。方法在2006年至2011年期间，对一级创伤中心登记进行了查询。以及进行胸腔手术以穿透胸腔创伤的患者。结果共分析了617例进行了CCT的患者，其中61.1％（617例中的371例）的X线平片检查正常（CXR）。在这些病例的14.0％（371个中的51个）中，CCT揭示了筛查CXR时未发现的发现。这些伤害大多数是隐性气胸或血胸（84.3％; 51中的43），其中27例（62.8％）接受了胸腔穿刺术。仅0.5％（371个中的2个）中，仅CCT的结果是否可导致手术指征：探索心包积血。在研究期间，我们患者的CCT总体使用率显着增加（28.8％至71.4％），并且在常规筛查CXR之后（23.3％至74.6％）显着增加。结论CCT在穿透性胸外伤期间的使用率增加了3.5倍研究期间同时增加不确定的临床意义的发现。筛查CXR正常的患者应进行3小时延迟CXR分期，连续体检和超声检查以明确创伤评估。 CTSNet分类：5根据损伤机制使用胸部计算机断层扫描（CCT），而无发现胸部损伤的物理表现或初始胸部X线照相（CXR）阴性，在钝器伤患者中变得司空见惯[

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