| 摘要: |
| 目的：探讨重症监护病房(ICU)应用床旁超声对胸部严重多发伤患者的诊断价值。方法：以2018年4月-2019年3月我院ICU 救治的120例严重多发伤患者为研究对象,由ICU医师对所有患者进行胸部床旁超声检查,在超声检查后2h内进行胸部X线检查。以CT检查或手术探查的诊断结果为金标准,观察床旁超声与X线的检查时间、诊断结果、诊断效能,对床旁超声的诊断效能进行多因素回归分析。结果：床旁超声与X线的检查时间分别为(4.1±1.5)min、(19.0±3.3)min,床旁超声的检查时间明显短于X线( P<0.05)；120例患者经CT检查或手术探查证实了60例阳性患者,合并胸腔积液28例、肺挫伤12例、气胸10例、心包积液7例、创伤性膈疝3例；床旁超声对胸腔积液(92.86% vs 71.43%)、肺挫伤(83.33% vs 50.00%)、气胸(90.00% vs 50.00%)、心包积液(100.00% vs 14.29%)的正确诊断符合率均明显高于X线( P<0.05)；床旁超声检查出54例阳性患者、66例阴性患者,X线检查出49例阳性患者、71例阴性患者,床旁超声的诊断结果一致性明显高于X线(P<0.05)；床旁超声的敏感度(90.00% vs 76.67%)、准确度(95.00% vs 85.83%)、阴性预测值(90.91% vs 80.28%)均明显高于X线(P<0.05),假阴性率(10.00% vs 23.33%)明显低于X线(P<0.05)；就诊时间>1h、多发脏器损伤、ICU医生工作年限>5年是影响床旁超声诊断效能的独立因素( P<0.05)。结论：结论：ICU应用床旁超声能够快速准确地评估胸部严重多发伤患者,缩短抢救时间,提高抢救时效性。 |
| 关键词: 严重多发伤 胸部 床旁超声 X线 诊断价值 |
| DOI： |
| 投稿时间：2019-03-15修订日期：2020-01-16 |
| 基金项目: |
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| Diagnostic value of bedside ultrasound on patients with severe multiple chest injury in ICU |
| wangxiangjiang |
| () |
| Abstract: |
| OBJECTIVE To discuss the diagnostic value of bedside ultrasound on patients with severe multiple chest injury in intensive care unit(ICU). METHODS 120 cases of patients with severe multiple injury which was taken as research objects in ICU of our hospital from April 2018 to March 2019. All the patients were detected by ICU physicians with bedside ultrasound and the patients were detected by X-ray within 2h after ultrasound examination. The diagnostic results of CT examination or surgical exploration were taken as gold standard, the inspection time, diagnostic results and diagnostic efficiency of bedside ultrasound and X-ray was observed. Multivariate regression analysis was performed on the diagnostic efficiency of bedside ultrasound. RESULTS The inspection time of bedside ultrasound and X-ray was (4.1±1.5)min, (19.0±3.3)min, respectively and the inspection time of bedside ultrasound was significantly shorter than that of X-ray( P<0.05). 120 patients were confirmed as 60 positive patients by CT examination or surgical exploration and 28 patients combined with pleural effusion, 12 patients combined with pulmonary contusion, 7 patients combined with pneumothorax, 3 patients combined with traumatic diaphragmatic hernia. The correct diagnostic coincidence rate of bedside ultrasound on pleural effusion (92.86% vs 71.43%), pulmonary contusion (83.33% vs 50.00%), pneumothorax (90.00% vs 50.00%), pericardial effusion (100.00% vs 14.29%) was significantly higher than that of X-ray (P<0.05).54 positive patients and 66 negative patients were check out by bedside ultrasound, 49 positive patients and 71 negative patients were check out by X-ray, the consistency of diagnostic results of bedside ultrasound was significantly higher than that of X-ray( P<0.05). |
| Key words: Severe multiple injury Chest Bedside ultrasound X-ray Diagnostic value |
