婴幼儿先天性心脏病术后床边胸片的临床应用评价  

Clinical Application of Bedside Chest Radiographs after CHD Surgery

作　　者：张晓军[1] 张新荣[1] 周静[2] 

机构地区：[1]南京医科大学附属南京儿童医院放射科,南京210008 [2]东南大学附属中大医院放射科,南京210009

出　　处：《现代生物医学进展》2007年第4期586-588,共3页Progress in Modern Biomedicine

摘　　要：评价床边胸片在婴幼儿先天性心脏病术后的临床应用价值,总结其常见并发症以提高阅片正确率。方法:55例先天性心脏病术后婴幼儿患者,男34例,女24例,年龄1月至36月(平均12．8月),其术后均使用移动X线机摄取床边胸片,总结分析术后胸片新出现的异常表现。结果:55例先天性心脏病惠儿术后床边胸片中,发现31例新出现异常X线表现,发生率为56．4%。其中胸腔积液12例;气胸9例,其中4例合并皮下气肿;肺不张5例;左下肺炎3例;肺水肿1例;膈肌抬高1例。婴幼儿先天性心脏病术后最常见的并发症中前三位的依次为:胸腔积液、气胸和肺不张,分别占38．7%、29．0%、16．1%。结论:床边胸片是及时全面了解先天性心脏病患儿术后胸部出现新异常的重要和有效的检查手段,且简便易行,能将婴幼儿不能主诉的影响减至最低,从而为临床提供及时的诊疗依据。Objective ：To evaluate the value of the bedside chest radiographs in infants with congenital heart diseases （CHD） after surgery and to sum up the common complications and improve the diagnosis accuracy rate. Methods：55 cases of infants with congenital heart disease were included, 34 were males and 21 were females, with age ranging from 1 month to 36 months （average 12.8 months）, the operations were done in the same conditions. The bedside chest radiographs were taken by portable X- ray equipment after the operation in the day and daily until the infant left the Intensive Care Unit, the radiography position was supine or semi-sitting. A total of 184 bedside chest radiographs were got, 3.35 chest radiographs per patient. The new abnormalities were reviewed by two experienced radiologists on the postoperative radiographs. The complications and its reasons of ChD surgery were analyzed retrospectively. Results：New abnormalities on postoperative chest radiographs were found in 31 cases among all the patients, the incidence rate was 56.4%, twelve patients with pleural effusion; nine cases with pneumothorax, including four cases with subcutaneous emphysema; five cases with pulmonary atelectasis; three cases with lower left pneumonia; one case with pulmonary edema and with diaphragm elevation. Pleural effusion, pulmonary atelectasis, and pneumothorax were the first three common complications in infants with congenital heart disease after surgery, the rate was 38.7%,29.0% and 16.1% respectively. Some serious complications including respiratory distress syndrome, wound infection, sternal dehiscence, mediastinal gas, pericardial gas and chest foreign bodies were not found in this group of patients. Conclusion：The bedside X-ray photograph is an important and valuable method for detecting overall new abnormalities in infants after CHD surgery in a timely and comprehensive way. This method is easier and it can decrease the impact to the minimum because of the infants not telling the states, thereby providing the

关 键 词：胸部 X线摄影 先天性心脏病手术 

分 类 号：R814.3[医药卫生—影像医学与核医学]