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胸部X线检查是诊断呼吸系统疾病的主要方法,它广泛地应用于指导临床进行诊断和治疗。在儿科的临床诊断和治疗中,由于小儿所独有的解剖生理特点,在阅读小儿胸片时容易出现误诊现象。就在临床工作中阅读小儿胸片的经验,谈以下几点应注意的问题。 1 胸部的投照技术条件 小儿胸部X线检查所见随呼吸而不同,胸部各器官和组织的X线形态均随呼吸相而产生相应的变化,在呼气相,两膈肌上升,肺血管充血,纵隔增宽遮蔽肺脏,使肺野面积大为缩小。因此,一张优良的胸片应有合适程度的吸气,以免与心肺疾病相混淆。此外,在透视和照片检查时,尽可能采用坐或站立后前位,因为这样能使膈肌下降纵隔投照放大率较小。但新生儿胸片应采用符合新生儿生理体位的仰卧正位,侧位片可观察纵隔及两肺下叶,弥补正位片的不足。因此,在进行病灶分析过程中,对胸片的投照技术条件应予以充分考虑。
Chest X-ray examination is the main method of diagnosis of respiratory diseases, it is widely used to guide the clinical diagnosis and treatment. In pediatric clinical diagnosis and treatment, due to the unique anatomy and physiology in children, misdiagnosis is prone to occur when reading pediatric chest radiographs. Just read the experience of pediatric chest X-ray in clinical work, the following points should pay attention to the problem. 1, the technical conditions of the projection of the chest Pediatric chest X-ray examination seen with the different breathing, the chest X-ray organs and tissues with the respiratory phase are the corresponding changes in the expiratory phase, the two diaphragm rise, pulmonary vascular congestion , Mediastinum widening cover the lungs, lung field area greatly reduced. Therefore, a good chest should have a suitable degree of inspiration, so as not to be confused with heart and lung disease. In addition, in the perspective and photo examination, as far as possible by sitting or standing after the front, because this can make the diaphragmatic down mediastinal projection magnification smaller. However, neonatal chest radiograph should be consistent with the physical position of the newborn supine orthopedic, lateral view of the mediastinum and the two lungs under the leaves, to make up for the lack of anteroposterior. Therefore, in the process of lesion analysis, the radiographs of chest radiograph should be fully considered.