- 期刊
- OpenAccess
胸片在新型冠狀病毒感染分流中的應用價值
The value of chest radiography in the patients triage during the outbreak of novel coronavirus pneumonia
摘要
目的：探討胸片在新型冠狀病毒（COVID - 19）肺炎爆發時期急重症病人分流中的應用價值。方法：對2022年12月15日～2023年1月31日診斷COVID- 19感染患者的首診胸片進行回顧性分析，通過對雙側肺野滲出性病變進行分區定量積分計算，探討新冠肺炎肺部滲出性病變的積分與臨床特徵的相關性。結果：106例患者胸片病變分佈以雙下肺為主（χ^2= 116.0, P <0.00）；左右肺、內外帶分佈無差異主（χ^2= 1.66, P = 0.79; 主χ^2= 0.73, P = 0.39）；病變形態以實質與間質混合型為主。有呼吸困難症狀、指尖氧飽和度（SpO_2）減低者，胸片積分分別高於無呼吸困難症狀及SpO_2正常者（t = 14.81/ t =8.69, P 均<0.00）。門急診患者胸片積分分佈低於住院患者主（χ^2= 9.25, P <0.05），好轉組胸片積分分佈低於死亡組患者主（χ^2 =7.00, P <0.05）。胸片積分高者住院時間相對較長（H = 6.45, P < 0.05）。胸片積分與肺炎嚴重程度呈正相關關係（r = 0.59, P <0.05）。結論：COVID-19感染疫情爆發時期胸片在急重症分流中具有一定應用價值果。
並列摘要
Objective: To explore the application value of chest radiography in patient triage during the outbreak of novel coronavirus pneumonia (COVID-19 pneumonia). Methods: A retrospective study of the first chest X-ray of 106 COVID-19 patients from December 15, 2022, to January 31, 2023, was performed. A severity score was determined to quantify the extent of pulmonary exudation on chest X-ray. The correlation between severity scores on chest X-ray and the severity of clinical features of infection was statistically analyzed. Results: On chest radiography, the distribution of lesions was mainly in the lower lung fields (χ^2=116.0, P <0.00), and there was no significant difference in the distribution of lesions in the left and right lungs (χ^2=1.66, P =0.79, χ^2=0.73, P =0.39). The lesions mainly demonstrated a mixture of consolidation and interstitial changes. Patients with symptoms of dyspnea and decreased fingertip oxygen saturation (SpO_2) had higher chest X-ray scores than those without symptoms of dyspnea and with normal SpO_2 (t =14.81, P <0.00, t =8.69, P <0.00). The chest X-ray scores of outpatients were mostly lower than those of inpatients (χ^2=9.25, P <0.05), and the scores were lower in the improved patients than in the deceased patients (χ^2=7.00, P <0.05). The patients with higher chest X-ray scores had a relatively longer hospital stay (H=6.45, P <0.05). The chest radiography severity scores were positively correlated with the clinical severity of COVID-19 (r =0.59, P <0.05).Conclusion: Chest radiography has certain application value in assessing the severity of infection which is helpful in the patient triage during the outbreak of COVID-19 infection.