兒科醫師可依據臨床症狀診斷急性鼻竇炎

目的：我們進行探討小兒科醫師是否可根據臨床症狀診斷急性鼻竇炎而無需會診耳鼻喉科醫師及進行影像學檢查之調查研究。方法：本研究將某區域醫院小兒科經由病人家長同意後臨床診斷為急性鼻竇炎之兒童為研究對象，分派至實驗組及對照組，實驗組為經兒科醫師診斷後會診耳鼻喉科醫師再做一次臨床診斷，對照組為不會診僅由兒科醫師做臨床診斷，兩組病人均作低劑量電腦斷層檢查。結果：本研究共有60名小兒科病人參與，其中有6名因故未完成低劑量之電腦斷層檢查。本研究統計之54名病人：實驗組為會診耳鼻喉科醫師之病人計有34名，另20名病人未會診為對照組。兒科醫師僅依臨床症狀診斷急性鼻竇炎的陽性預測值為87.0%，兩組病人並無顯著差異。影像學檢查可以提高診斷之陽性預測值，但未達顯著差異。結論：由本研究顯示兒科醫師僅依臨床症狀診斷急性鼻竇炎之正確率為87.0%，做了低劑量電腦斷層檢查及會診耳鼻喉科醫師並無顯著增加診斷正確率。

關鍵字

兒童急性鼻竇炎；電腦斷層檢查；診斷

並列摘要

Background and Purpose: We conduct this study to evaluate if Pediatricians can diagnose acute sinusitis correctly without image study and consultation with ENT doctors. Methods: Patients who were diagnosed with acute sinusit is by pediatricians according to clinical symptoms were enrolled in this study. Low dose CT was performed for all patients. These patients were divided into two groups. Patients in the first group were diagnosed by pediatrician alone, and patients in the second group were diagnosed by pediatricians and ENT doctors. Results: Among 54 patients completing this study, 20 patients were diagnosed by pediatricians alone and 34 patients were diagnosed by both pediatricians and ENT doctors. The positive predictive value of pediatricians' correct diagnosis according to clinical symptoms is 87.0%. There were no significant differences between these two groups. The correct diagnostic rate of clinical diagnosis was 87.0%, and the rate was elevated to 90.7% with image study. There was no significant difference in both groups. Conclusion: Image study and consultation with ENT doctors are not mandatory for pediatrician to diagnose acute sinusitis.

並列關鍵字

acute sinusitis ； CT scanner ； diagnosis

國際替代計量

兒科醫師可依據臨床症狀診斷急性鼻竇炎

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