中华急诊医学杂志
中華急診醫學雜誌
중화급진의학잡지
CHINESE JOURNAL OF EMERGENCY MEDICINE
2014年
12期
1366-1370
,共5页
张山红%张洪波%刘笑雷%张国强
張山紅%張洪波%劉笑雷%張國彊
장산홍%장홍파%류소뢰%장국강
超声检查%胸部X线检查%重症肺炎
超聲檢查%胸部X線檢查%重癥肺炎
초성검사%흉부X선검사%중증폐염
Ultrasonic inspection%Chest X-ray%Severe pneumonia
目的 分析重症肺炎患者的肺部超声特征,探讨床旁超声诊断肺炎的临床价值.方法 以急诊留院治疗的疑诊重症肺炎患者为研究对象,对患者进行胸部X线检查(chest x-rayCXR)、肺部超声检查及胸部CT检查;分析床旁超声诊断重症肺炎的敏感性、特异性、阳性预测值、阴性预测值及准确性,并与CXR进行比较.结果 重症肺炎组出现肺实变的患者例数、有胸膜改变的肋间个数、胸膜下病变个数以及合并有胸腔积液的患者例数均高于非重症肺炎组.床旁超声诊断重症肺炎的敏感性为95.7％,特异性为97.1％,阳性预测值为98.5％,阴性预测值为89.5％,准确性为96.2％.与CXR比较,两者在敏感性、阴性预测值和准确性上差异具有统计学意义.结论 床旁超声是诊断重症肺炎可靠的辅助检查方法,诊断的敏感性、阴性预测值和准确性优于CXR,广泛地开展胸部床旁超声检查可以提高重症肺炎的快速诊断,确立及时正确的治疗.
目的 分析重癥肺炎患者的肺部超聲特徵,探討床徬超聲診斷肺炎的臨床價值.方法 以急診留院治療的疑診重癥肺炎患者為研究對象,對患者進行胸部X線檢查(chest x-rayCXR)、肺部超聲檢查及胸部CT檢查;分析床徬超聲診斷重癥肺炎的敏感性、特異性、暘性預測值、陰性預測值及準確性,併與CXR進行比較.結果 重癥肺炎組齣現肺實變的患者例數、有胸膜改變的肋間箇數、胸膜下病變箇數以及閤併有胸腔積液的患者例數均高于非重癥肺炎組.床徬超聲診斷重癥肺炎的敏感性為95.7％,特異性為97.1％,暘性預測值為98.5％,陰性預測值為89.5％,準確性為96.2％.與CXR比較,兩者在敏感性、陰性預測值和準確性上差異具有統計學意義.結論 床徬超聲是診斷重癥肺炎可靠的輔助檢查方法,診斷的敏感性、陰性預測值和準確性優于CXR,廣汎地開展胸部床徬超聲檢查可以提高重癥肺炎的快速診斷,確立及時正確的治療.
목적 분석중증폐염환자적폐부초성특정,탐토상방초성진단폐염적림상개치.방법 이급진류원치료적의진중증폐염환자위연구대상,대환자진행흉부X선검사(chest x-rayCXR)、폐부초성검사급흉부CT검사;분석상방초성진단중증폐염적민감성、특이성、양성예측치、음성예측치급준학성,병여CXR진행비교.결과 중증폐염조출현폐실변적환자례수、유흉막개변적륵간개수、흉막하병변개수이급합병유흉강적액적환자례수균고우비중증폐염조.상방초성진단중증폐염적민감성위95.7％,특이성위97.1％,양성예측치위98.5％,음성예측치위89.5％,준학성위96.2％.여CXR비교,량자재민감성、음성예측치화준학성상차이구유통계학의의.결론 상방초성시진단중증폐염가고적보조검사방법,진단적민감성、음성예측치화준학성우우CXR,엄범지개전흉부상방초성검사가이제고중증폐염적쾌속진단,학립급시정학적치료.
Objective To evaluate the diagnostic performances of bedside lung ultrasound (US) and chest radiography (CXR) in patients with severe pneumonia.Method Lung ultrasound (US),CXR and chest CT were performed in sequence in adult patients admitted to the emergency department for suspected acute respiratory failure caused by severe pneumonia.Here,chest CT served as a" golded standard" for comparison.The diagnostic efficacy of US for the detection of severe pneumonia,defined as rapidity and accuracy (sensitivity,specificity,positive predictive value,negative predictive value) were compared with CXR.Results The number of patients with consolidation of lung,pleural alteration,subpleural pathological changes,and pleural effusion in the severe pneumonia group was higher than that in the nonpneumonia group.Sensitivity of bedside ultrasound examination for the diagnosis of severe pneumonia was 95.7％,and specificity 96.3％,positive predictive value 95.7％,negative predictive value 96.3％,and accuracy 96.0％.There were differences in sensitivity,negative predictive value and accuracy found between CXR and US.Conclusions Bedside chest ultrasound is a reliable device for the diagnosis of severe pneumonia,and superior to CXR in this setting,allowing a more prompt diagnosis and treatment.
