论文部分内容阅读
目的:评估重症监护室的重症感染或者脓毒性休克患者尿常规检查和胸部X线检查的准确性。方法:回顾性分析我院进入重症监护室的确诊为重症感染或者脓毒性休克的患者,收集所有入组患者的个人情况,进入监护室以后的尿液检查结果、胸部X线检查结果,以及体液细菌学培养的结果,分析上述数据与诊断泌尿系感染或者肺部感染之间关系。结果:我们回顾了400例患者,其中70例患者确诊为重症感染或者脓毒性休克,其中13例患者确诊为泌尿系感染(尿常规,白细胞>10/高倍镜视野),敏感性和特异性分别为81%(95%CI 0.67-0.92)和65%(95%CI 0.51-0.75);36例患者确诊为肺部感染,胸部X线检查诊断肺部感染的的敏感性和特异性分别为57%(95%CI 0.45-0.69)和92%(95%CI 0.82-0.93)。结论:对于脓毒血症或者脓毒性休克的患者,胸部X线检查敏感性较低,这可能与肺部X线检查干扰因素较多,并且肺部感染发生到出现影像学变化有一定的时间间隔;而尿液分析敏感性较高,但是也可能由于尿液中上皮细胞的存在而干扰诊断。
PURPOSE: To assess the accuracy of urinalysis and chest X-ray findings in critically ill intensive care units or patients with septic shock. Methods: A retrospective analysis of our hospital admitted to intensive care unit diagnosed as severe infection or septic shock patients, all patients included in the collection of personal circumstances, into the care room after the urine test results, chest X-ray findings, and body fluids The results of the bacteriological culture were analyzed for the relationship between the above data and the diagnosis of urinary tract infection or pulmonary infection. RESULTS: We reviewed 400 patients, 70 of whom were diagnosed as having severe infection or septic shock. Thirteen patients were diagnosed as having urinary tract infections (urine routine, WBC> 10 / high magnification) with sensitivity and specificity Were 81% (95% CI 0.67-0.92) and 65% (95% CI 0.51-0.75). The sensitivity and specificity of chest X-ray in diagnosis of pulmonary infection in 36 patients were 57 % (95% CI 0.45-0.69) and 92% (95% CI 0.82-0.93). CONCLUSIONS: Chest radiography is less sensitive in patients with sepsis or septic shock, which may be associated with a greater number of lung X-ray findings and time to pulmonary imaging with imaging changes Interval; and urine analysis is more sensitive, but may also interfere with the diagnosis due to the presence of epithelial cells in the urine.