心肺联合超声对急性呼吸窘迫综合征的诊断价值  

Diagnostic value of integrated cardiopulmonary sonography in acute respiratory distress syndrome

作　　者：黄道政[1] 马欢[2] 王首红[1] 温剑艺[1] 廖小龙[1] 郭伟新[1] 王中华[1] 吴岩[1] 覃铁和[1] 

机构地区：[1]广东省人民医院广东省医学科学院,广东省老年医学研究所ICU,广东广州510080 [2]广东省中医院重症医学科,广东广州510120

出　　处：《中华危重病急救医学》2016年第11期1039-1042,共4页Chinese Critical Care Medicine

摘　　要：急性呼吸窘迫综合征（ARDS）柏林标准强化了ARDS定义的可行性、可靠性和有效性。柏林标准在影像学诊断方面明确指出，可采用胸部CT代替X线胸片，但胸部CT因患者转运风险大、费用高、放射性暴露等因素限制了其在危重患者中的应用，而X线胸片对ARDS的评价标准仍不清晰，导致ARDS诊断特异性下降。ARDS早期诊断尤其是影像学诊断仍然面临诸多困难。近年来床旁超声（PoCUS）因其具有可实时、动态评估心肺功能的变化等特点，越来越受到临床医师的关注和重视。结合ARDS柏林诊断标准及内涵，我们认为心肺联合超声可能为ARDS的早期诊断提供新的依据，甚至建立新的诊断标准。The Berlin definition of acute respiratory distress syndrome （ARDS） has strengthened the feasibility, reliability and validity of clinical application. It was pointed out clearly that computed tomography （CT） scan can be used instead of chest X-ray radiograph for chest imaging diagnosis in Berlin criteria. However, thoracic CT scan was limited in the field of critical care medicine due to the high risk of transportation, high cost, radiation exposure and other factors. But the diagnostic criteria of chest X-ray for ARDS is still unclear, which resulted in a decline in diagnostic specificity of ARDS. The early diagnosis of ARDS is still rcmaining extremely challenging, especially in chest imaging diagnosis. Point-of-care ultrasonography （PoCUS） with the characteristics of real time and dynamic evaluation of cardiopulmonary function has gained more and more attention of clinicians in recent years. Combined with the diagnostic criteria and connotation of ARDS in Berlin definition, integrated cardiopulmonary sonography may provide a new reference for early diagnosis, and even create new criteria for the diagnosis of ARDS.

关 键 词：心肺联合超声 肺部超声 急性呼吸窘迫综合征 诊断 

分 类 号：R563.8[医药卫生—呼吸系统]