机械通气患者胸腔积液分布形态与精确定量的研究  

Study on distribution and precise quantification of pleural effusion in mechanically ventilated patients

作　　者：张茂[1] 杨俭新[1] 刘志海[1] 干建新[1] 徐少文[1] 江观玉[1] 

机构地区：[1]浙江大学医学院附属第二医院急诊科浙江大学急救医学研究所,杭州310009

出　　处：《中国急救医学》2007年第10期874-877,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的了解机械通气患者胸腔内积液分布的形态特征,为利用超声对胸腔积液进行精确定量建立一个新的方法。方法37例合并胸腔积液的机械通气患者于呼气末进行胸部CT扫描,利用软件定量分析CT图像,获取胸腔积液量(V)、积液高度(H)、中间积液层的液体厚度(T)及面积(S);建立V与H、T、S的一元和二元回归方程,比较它们估算积液量的精确度。结果机械通气患者胸腔内积液的体积分布形态近似呈线性,左右侧相似;以S和H建立的二元线性回归方程估算积液量与实际值的相关性最好(r=0.958,P<0.001),精确度最好[与实际值误差的95%分布范围为(-3±137)mL]。结论利用机械通气患者胸腔积液的高度和中间积液层的面积可以非常精确地估算积液量,为临床应用超声对胸腔积液进行精确定量提供了新方法。Objective To explore the distribution characters of pleural effusion in mechanically ventilated patients and to find a new alternative to precisely quantify effusions by ultrasonography. Methods Thoracic spiral computer tomography were performed in 37 mechanically ventilated patients with pleural effusion. CT images were analyzed with special software to acquire total volume of effusion （ V ）, height of effusion （ H ）, thickness （ T ） and area （ A ） of effusion on the middle slice. Linear and multiple linear regression analysis between V and H, T, S were done. Different formulas were compared by their precision to estimate effusion volume. Results Distribution of effusion volume was approximately linear both in left and fight thoraces of mechanically ventilated patients. The best formula to estimate effusion volume consisted of S and H, with the best correlation （ r =0. 958, P 〈0.001 ） and precision [ difference between estimated and actual volume had a 95% range of （ -3 ±137） mL]. Conclusion Volume of pleural effusion can be well estimated by H and S in mechanically ventilated patients, and thus provide a new alternative to precisely quantify pleural effusion by uhrasonography.

关 键 词：机械通气 胸腔积液 定量 

分 类 号：R459.6[医药卫生—治疗学] R561[医药卫生—临床医学]