| 摘要: |
| 目的：探讨多器官床旁超声在重症患者脱机评估中的价值。方法：回顾性纳入2021年10月~2023年10月于本院重症监护室行机械通气治疗的200例重症患者,作为研究对象。收集患者相关一般资料,并对所有研究对象进行多器官床旁超声检查,Logistic回归分析患者脱机失败的影响因素。受试者工作特征曲线(ROC)曲线分析多器官床旁超声在重症患者脱机中的预测价值。结果：脱机失败组患者左室射血分数(LVEF)、膈肌增厚率(DTF)、膈肌移动度(DE)均低于脱机成功组,肺超声评分(LUS)高于脱机成功组患者(P<0.05)；多因素logistics回归分析结果显示,LUS是患者脱机失败的危险因素(P＜0.05),LVEF、DTF、DE是患者脱机失败的保护因素(P＜0.05)。ROC结果显示LVEF、LUS、DTF、DE及联合预测重症患者脱机失败的AUC为0.767、0.756、0.814、0.777、0.945；曲线下面积比较结果显示,联合预测优于单独预测(z=5.224、5.435、4.755、5.725,P<0.05)。结论：多器官联合床旁超声在重症患者脱机评估中具有一定的预测价值。 |
| 关键词: 多器官 床旁超声 机械通气 重症患者 |
| DOI： |
| 投稿时间：2024-03-27修订日期：2024-05-08 |
| 基金项目: |
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| Value of multi-organ bedside ultrasound in off-line evaluation of critically ill patients |
| Liu Xuelin,Zhang Jianlei,Wang Ting,Liu jiangyun,Yang Rong,Wang Shengqi,Gao Jiayu |
| (Department of Ultrasound Diagnosis of Yan ''an People''s Hospital,Yan''an,Shaanxi;Department of Ultrasound Diagnosis of Yan &#39;&#39;an People&#39;&#39;s Hospital,Yan&#39;&#39;an,Shaanxi) |
| Abstract: |
| Objective: To explore the value of multi-organ bedside ultrasound in off-line evaluation of critically ill patients. Methods: From October 2021 to October 2023, 200 critically ill patients who were treated with mechanical ventilation in the intensive care unit of our hospital were retrospectively included as the research object. General data of patients were collected, and all subjects were examined by multi-organ bedside ultrasound. Logistic regression was used to analyze the influencing factors of patients" offline failure. Receiver operating characteristic curve (ROC) curve analysis of the predictive value of multi-organ bedside ultrasound in critically ill patients off-line. Results: The left ventricular ejection fraction (LVEF), diaphragmatic thickening rate (DTF) and diaphragm displacement (DE) in the off-line failure group were lower than those in the off-line success group, and the lung ultrasound score (LUS) was higher than those in the off-line success group (P<0.05). Multivariate logistics regression analysis showed that LUS was the risk factor of offline failure (P<0.05), LVEF, DTF and DE were the protective factors of offline failure (P<0.05). The ROC results showed that the AUC of LVEF, LUS, DTF, DE and their combination in predicting offline failure of critically ill patients were 0.767, 0.756, 0.814, 0.777 and 0.945. The comparison of the area under the curve shows that the joint prediction is better than the single prediction (z=5.224, 5.435, 4.755, 5.725, P<0.05). Conclusion: Multi-organ combined with bedside ultrasound has certain predictive value in off-line evaluation of critically ill patients. |
| Key words: Multiple organs Bedside ultrasound Mechanical ventilation Patient in critical condition |
