| 摘要: |
| 目的 系统评价超声对外伤引起胸腔内出血的诊断价值。方法 计算机检索The Cochrane Library、PubMed、Science Citation Index、CNKI、CBM、VIP、WanFang Data,检索时限为建库至2017年5月8日,由2名评价者独立筛选文献并提取数据,纳入研究的方法学质量用QUADAS质量评价工具评价,用Meta-disc 1.4软件进行统计分析。结果 共纳入8个研究,包括2082例受试者,Meta分析结果显示,超声对外伤引起的胸腔内出血诊断研究Sen合并、Spe合并、+LR合并、-LR合并、DOR合并及95% CI为0.94[95%CI(0.92,0.96)]、0.99[95%CI(0.98,0.99)]、43.84[95%CI(19.08,100.71)]、0.10[95%CI(0.01,1.85)]、496.73[95%CI(71.60,3446.26)],AUC为0.99,SE(AUC)为0.0020。亚组分析提示,以胸腔置管引流/CT检查为金标准的研究Sen、Spe、DOR及95% CI分别为0.99[95%CI(0.97,0.99)]、0.99[95%CI(0.98,0.99)]、6760.22[95%CI(2406.59,18989.75)],AUC为0.99。以CT检查为金标准的研究Sen、Spe、DOR及95% CI分别为0.74[95%CI(0.64,0.83)]、0.97[95%CI(0.95,0.99)]、64.07[95%CI(10.64,385.82)],AUC为0.98。结论 胸部超声不仅能准确地判定胸腔内出血,而且就血胸、胸腔积液的病人而言能替代胸片、CT成为常规检查,值得临床推广使用。 |
| 关键词: 胸部外伤 胸腔 出血 超声 诊断试验 Meta分析 |
| DOI： |
| 投稿时间：2017-09-13修订日期：2017-09-13 |
| 基金项目:甘肃卫生行业科研计划项目(GSWST09-19)、甘肃省科技支撑计划资助项目(1104FKCA106)、2015年兰州军区面上项目A类(CLZ15JA04) |
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| Diagnostic Value of Ultrasonography for Thoracic Cavity Hemorrhage Caused by Chest Trauma : A Meta-analysis |
| Cao Huihui,Meng Hui |
| (Clinical Medicine College of Gansu University of Traditional Chinese Medicine;Department of Thoracic Surgery,Hospital of Lanzhou Army) |
| Abstract: |
| Objective To systematically review the diagnostic value of ultrasonography for thoracic cavity hemorrhage caused by chest trauma. Methods Databases including The Cochrane Library,PubMed,Science Citation Index,CNKI,CBM,VIP,WanFang Data were searched for diagnostic tests about chest ultrasongography for thoracic cavity hemorrhage caused by chest trauma from inception to May 8,2017. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies by QUADAS tool. Meta-analysis was performed using Meta-Disc 1.4 software. Results A total of 8 studies involving 2082 patients were included. The results of meta-analysis showed that Sen,Spe,+LR,-LR,DOR and its 95%CI were 0.94(95%CI 0.92 to 0.96),0.99(95%CI 0.98 to 0.99),43.84(95%CI 19.08 to 100.71),0.10 (95%CI 0.01 to 1.85),496.73(95%CI 71.60 to 3446.26),AUC was 0.99,SE(AUC) was 0.0020. In the subgroup analysis, for grade of thoracic drainage and CT, the results of meta-analysis showed that the Sen,Spe,DOR and its 95%CI were 0.99(95%CI 0.97 to 0.99), 0.99(95%CI 0.98 to 0.99),6760.22(95%CI 2406.59 to 18989.75), respectively,AUC was 0.99. For grade of CT, the Sen,Spe,DOR and its 95%CI were 0.74(95%CI 0.64 to 0.83),0.97(95%CI 0.95 to 0.99) and 64.07(95%CI 10.64 to 385.82),AUC was 0.98.Conclusions The chest ultrasonography can accurately determine the intrathoracic bleeding. For the patients who with pleural effusion or hemothorax, it is worthy to use ultrasonography replace the chest X-ray and CT as a routine test. |
| Key words: Chest trauma Thoracic cavity Hemorrhage Ultrasonography Diagnostic test Meta-analysis |
