急诊床旁肺部超声在气胸患者快速诊断中的应用  

Application of bedside lung ultrasound in emergency for rapid diagnosis of pneumothorax

作　　者：鄢涛[1] 谢雯雯 刘小琴[1] 姜伟[1] 杨勇[1] 余函阳 李芝霖 巫金 阳毅[1] 唐一男 杨南岚[1] 唐小曲 廖春燕 陈熙[1] YAN Tao;XIE Wen-wen;LIU Xiao-qin;JIANG Wei;YANG Yong;YU Han-yang;LI Zhi-lin;WU Jin;YANG Yi;TANG Yi-nan;YANG Nan-lan;TANG Xiao-qu;LIAO Chun-yan;CHEN Xi(Emergency Department, People's Hospital of Deyang City, Deyang 618000, Sichuan, CHINA;The Third People's Hospital of Mianyang, Mianyang 621000, Sichuan, CHINA)

机构地区：[1]德阳市人民医院急诊科,四川德阳618000 [2]绵阳市第三人民医院,四川绵阳621000

出　　处：《海南医学》2019年第7期885-887,共3页Hainan Medical Journal

基　　金：四川省教育厅资助项目(编号:SWFZ16)

摘　　要：目的探讨急诊床旁肺部超声在气胸患者快速诊断中的应用价值。方法回顾性分析德阳市人民医院急诊科2017年8月至2018年8月急诊接诊的103例疑似诊断气胸患者的临床资料,所有患者均进行急诊床旁肺超声检查和急诊胸部CT检查。比较两种检查方法的转运时间、检查报告时间、费用、诊断效率、检查方法一致性,并对肺部超声操作者进行问卷调查。结果 103例患者的急诊床旁肺超声转运时间和检查报告时间分别为(0.48±0.11) min和(12.45±5.24) min,明显比急诊胸部CT检查的(10.24±1.88) min和(15.85±2.34) min短,差异均具有统计学意义(P<0.05);急诊胸部CT费用约为急诊肺部超声的3倍;两种检查方法进行一致性比较,肯德尔和谐系数为0.625 9,两种检查方法具有一致性;急诊床旁肺部超声检查敏感性为91.17%(62/68),特异性为88.57%(31/35),准确性90.29%(93/103)。操作者调查问卷显示急诊床旁肺部超声具有快速、易操作、无辐射和便携特点。结论在临床上快速诊断气胸中,急诊床旁肺部超声检查具有快速、易操作、准确性高、无辐射、便携和费用低的特点,缩短了诊断时间,提高了急救效率,适合在基层医院急诊抢救中推广。Objective To explore the application value of bedside lung ultrasound in emergency for rapid diagnosis of pneumothorax. Methods The clinical data of 103 suspected pneumothorax patients admitted to the Emergency Department at People’s Hospital of Deyang City from August 2017 to August 2018 were retrospectively analyzed, and all patients underwent beside lung ultrasound and chest CT scan in emergency. The patients’ transfer time, inspection report time, cost, diagnostic efficiency, and consistency of inspection methods were compared between the two methods, and a questionnaire survey was conducted on the operators of bedside lung ultrasound in emergency. Results The patients’ transport time and inspection report time of 103 patients who underwent bedside lung ultrasound in emergency were respectively(0.48 ± 0.11) minutes and(12.45 ± 5.24) minutes, which were significantly shorter than corresponding(10.24 ± 1.88) minutes and(15.85 ± 2.34) minutes of patients who underwent bedside chest CT scan in emergency(P<0.05). The cost of chest CT in emergency was about three times that of beside lung ultrasound. Consistent comparison of the two inspection methods, the Kendall Harmony Coefficient was 0.6259, then the two methods were consistent. The sensitivity, specificity, and accuracy of bedside ultrasound in emergency were respectively 91.17%(62/68), 88.57%(31/35), and 90.29%(93/103). The operator questionnaire showed that bedside lung ultrasound in emergency has the characteristics of rapid diagnosis, easy operation, no radiation and portability. Conclusion In clinical rapid diagnosis of pneumothorax, bedside lung ultrasonography in emergency has the characteristics of fast, easy operation, high accuracy, no radiation, portability and low cost, which shortens the diagnosis time, and improves the efficiency of emergency treatment, and is suitable for promotion in emergency rescue in primary hospitals.

关 键 词：急诊床旁肺部超声 胸部CT 气胸 急诊急救 基层医院 

分 类 号：R561.4[医药卫生—呼吸系统]