| 摘要: |
| 目的 探讨基于床旁超声在重症肺炎机械通气患者中的临床效果。方法 以我院2016年5月～2018年8月重症医学科呼吸机通气肺炎患者87例为研究对象,分别采用对患者进行床旁B超、CT及实验室检查；依据患者肺炎严重程度分为重症肺炎组47例,非重症肺炎组40例；对比床旁B超对重症肺炎机械通气患者的诊断价值。结果 床旁B超显示重症肺炎肺实变(68.09%)、胸膜下病变个数(4.73±2.57个)、胸膜改变肋间个数(8.12±2.26个)、肺超声评分(21.31±5.26分)与非重症肺炎组(7.50%,2.02±1.08个,2.47±1.02个,30.86±5.72分)相比差异明显(P<0.05)；重症肺炎组胸膜腔积液患者(38.30%)与非重症肺炎组(17.75%)相比比例较高,但差异无统计学意义(P>0.05)。床旁B超诊断40例为重症肺炎,准确诊断39例；CT诊断41例为重症肺炎,准确诊断40例。床旁B超与CT检查项目敏感性与特异性均较高,二者相比差异无统计学意义(P>0.05)。重症肺炎组,死亡9例,存活38例。床旁B超显示重症肺炎死亡患者肺实变(100%)、胸膜下病变个数(5.31±2.27个)、胸膜改变肋间个数(9.25±2.46个)、肺超声评分(21.31±5.26分)与存活患者(60.53%,3.79±1.97个,6.54±1.85个,25.27±2.85分)相比差异明显(P<0.05)；死亡患者胸膜腔积液患者(77.78%)与存活患者组(55.26%)相比比例较高,但差异无统计学意义(P>0.05)。结论 床旁B超能够准确重症肺炎机械通气患者肺部特征,对患者诊断及预后具有重要价值。 |
| 关键词: 床旁超声 重症肺炎 机械通气患者 临床效果 |
| DOI： |
| 投稿时间：2020-03-30修订日期：2020-05-15 |
| 基金项目: |
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| Clinical comparative research of bedside ultrasound in patients with severe pneumonia mechanical ventilation |
| Liu Xingzhao,Hu Qingmao,Hu Yong,Huang Yong,Li Yinchun |
| () |
| Abstract: |
| Objective To investigate the clinical effect of bedside ultrasound in patients with severe pneumonia and mechanical ventilation. Methods A total of 87 patients with pneumonia in ventilator ventilation in the Department of Critical Medicine from May 2016 to August 2018 in our hospital were taken as the research objects. Patients were examined by bedside ultrasound, CT, and laboratory. The diagnostic value of B-mode ultrasound in patients with severe pneumonia and mechanical ventilation. Results Bedside B-ultrasound showed the pulmonary consolidation of severe pneumonia (68.09%), the number of subpleural lesions (4.73 ± 2.57), and number of intercostal changes of pleura (8.12 ± 2.26) and pulmonary ultrasound scores (21.31 ± 5.26)of the severe pneumonia groups compared with the non-severe pneumonia groups (7.50%, 2.02 ± 1.08, 2.47 ± 1.02, 30.86 ± 5.72) were significantly different (P <0.05);The patients with pleural effusion in the severe pneumonia group (38.30%) compared with the non-severe pneumonia group (17.75%) has a higher proportion, but the difference was not statistically significant (P> 0.05). The sensitivity and specificity of bedside ultrasound and CT examination items were both higher, and there was no significant difference between the two (P> 0.05). In the severe pneumonia group, 9 died and 38 survived. Bedside ultrasonography showed lung consolidation (100%), number of subpleural lesions (5.31 ± 2.27), number of intercostal intercostal changes (9.25 ± 2.46), and pulmonary ultrasound score (21.31 ± 5.26) in patients with severe pneumonia. Compared with the surviving patients (60.53%, 3.79 ± 1.97, 6.54 ± 1.85, 25.27 ± 2.85 points), the difference was significant (P <0.05); The patients with pleural effusion (77.78%) and the surviving patients (55.26) %), But the difference is not statistically significant (P> 0.05). Conclusion Bedside ultrasound can accurately determine the lung characteristics of patients with severe pneumonia and mechanical ventilation, which is of great value for diagnosis and prognosis of patients. |
| Key words: Bedside ultrasound Severe pneumonia Mechanically ventilated patients Clinical effect |
