床旁肺部超声对急性呼吸衰竭病因的诊断价值

梅勇; 陈旭锋; 黄培培; 张劲松

doi:10.13201/j.issn.1009-5918.2016.08.016

床旁肺部超声对急性呼吸衰竭病因的诊断价值

- 南京医科大学第一附属医院(江苏省人民医院)急诊中心(南京, 210029)

详细信息

通讯作者: 张劲松,E-mail:zhangjso@sina.com

中图分类号: R562

收稿日期: 2016-06-27

Diagnostic value of point-of-care lung ultrasonography for acute respiratory failure

- Department of Emergency, First Affiliated Hospital of Nanjing Medical University(Jiangsu Province Hospital), Nanjing 210029, China

More Information

Corresponding author: ZHANG Jingsong, E-mail: zhangjso@sina.com

Received Date: 27 June 2016

摘要

摘要: 目的:探讨床旁肺部超声对急诊急性呼吸衰竭患者的诊断价值。方法:连续选取2014-11-2015-04我院急诊抢救室急性呼吸衰竭患者120例。肺部超声组采用改良BLUE方案对患者进行诊断;常规检查组采用常规检查方法。比较2组诊断的正确率及确诊时间。评估床旁肺部超声对急性呼吸衰竭常见原因诊断的特异性及敏感性。结果:肺部超声组确诊时间少于常规检查组(P<0.05),诊断正确率也高于常规检查组(P<0.05)。床旁肺部超声对急性肺水肿诊断的敏感性为88.8%,特异性为98.8%;对肺炎的诊断敏感性为82.1%,特异性为96.8%;对慢性阻塞性肺病或者哮喘诊断的敏感性为89.7%,特异性为96.4%;对气胸诊断的敏感性为92.8%,特异性为97.2%;对肺栓塞诊断的敏感性为75.0%,特异性为97.2%。结论:对急诊急性呼吸衰竭患者,床旁肺部超声可以减少诊断时间,增加诊断的正确率,值得推广应用。
- 急诊 /
- 急性呼吸衰竭 /
- 肺部超声
Abstract: Objective:To evaluate the diagnostic value of point-of-care lung ultrasonography (LUS) in patients with acute respiratory failure (ARF) admitted to the emergency department (ED).Method:Patients with ARF admitted to the ED of First Affiliated Hospital of Nanjing Medical University from November 2014 to April 2015 were selected.Lung ultrasonography and routine examination were performed in sequence.The final diagnosis was determined by the panel of experts.The diagnostic efficacy of LUS,defined as rapidity and accuracy (sensitivity,specificity,positive predictive value,negative predictive value) were compared with that of routine examination.Result:A total of 120 patients were included.The LUS approach had a shorter time to diagnosis and a higher diagnostic accuracy than the routine examination (P<0.05).LUS had high sensitivity and specificity for the diagnosis of acute pulmonary edema,(sensitivity 88.8%,specificity 98.8%),pneumonia (sensitivity 82.1%,specificity 96.8%),COPD/asthma (sensitivity 89.7%,specificity 96.4%),pneumothorax (sensitivity 92.8%,specificity 97.2%),pulmonary embolism (sensitivity 75.0%,specificity 97.2%).Conclusion:The use of LUS appears to be an attractive complementary diagnostic tool.Emergency Medicine physicians should be encouraged to learn LUS.
- emergency /
- acute respiratory failure /
- lung ultrasonography

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