计算机X线摄影床旁胸片血管蒂宽度和心胸比例测量对老年重症患者左心衰肺水肿的诊断价值

Diagnostic value of the measurement of vascular pedicle width and carrdiothoracic ratio using bedside chest computed radiography(CR)on pulmonary edema due to acute left cardiac dysfunction in elderly critically ill patients

目的 探讨老年重症患者左心功能不全肺水肿与床边胸部计算机 X线摄影 (CR)血管蒂的宽度 (VPW)和心胸比例 (CTR)的测量值对老年重症患者左心功能不全肺水肿的诊断价值。方法 对 60例老年重症患者左心功能不全肺水肿患者 (肺水肿组 )和 60例无左心功能不全表现的老年重症患者患者 (对照组 )床边胸部 CR在工作站进行 VPW和 CTR的测量。结果 VPW和 CTR的平均值在肺水肿组显著高于对照组 (P<0 .0 0 1 ) ,对照组和肺水肿组 VPW≥ 70 mm者分别占 1 1 .7% (7/ 60 )和 96.7% (58/ 60 ) ,差异非常显著。其中对照组无 >80 mm者而肺水肿组占33.3% ,对照组和肺水肿组 CTR≥ 0 .54者分别占 48.3% (2 9/ 60 )和 93.3% (56/ 60 ) ,差异非常显著 ,其中对照组和肺水肿组 CTR≥ 0 .63分别为8.3%和 35%。结论 床边胸部 CR的 VPW测量值可以作为老年重症患者左心功能不全肺水肿诊断的一个重要参考标准 ,结合心胸比例的测量对老年肺水肿的诊断有一定帮助作用 ,同时也有一定限度。

Objective To investigate the diagnostic value of the measurement of vascular pedicle width (VPW) and carrdiothoracic ratio (CTR) using bedside chest computed radiography (CR) on pulmonary edema due to acute left cardiac dysfunction in elderly critically ill patients. Methods VPW and CTR were measured with CR in workstation in pulmonary edema group (n=60) and control group (n=60). Results The mean value of VPW and CTR in pulmonary edema group was significantly higher than that in control group (P<0.001). In control group and in pulmonary edema group, the patients with VPW≥70mm were 11.7% (7/60) and 96.7% (58/60) respectively, the patients with CTR≥0.54 were 48.3% (29/60) and 93.3% (56/60), and the patients with CTR≥0.63 were 8.3% and 35%, respectively. These differences between two groups were significant. Conclusions The value of VPW of bedside chest CR can be an important reference on diagnosing pulmonary edema due to acute left cardiac dysfunction in elderly critically ill patients, and VPW together with CTR can help to diagnose this disease to a certain extent but also have some limitations in application.