床旁超声在新型冠状病毒肺炎应急病房中的应用  

Application of bedside ultrasound in emergency ward of coronavirus disease 2019

作　　者：张晖[1,2] 刘建建 黄晶晶[1] 施霞 马鑫 浦徐娟[1] 王国英 薛芳[1] 武豆[1] 曹梦云 陆清 ZHANG Hui;LIU Jianjian;HUANG JingJing;SHI Xia;MA Xin;PU Xujuan;WANG Guoying;XUE Fang;WU Dou;CAO Mengyun;LU Qing(Department of Ultrasound,Shanghai Public Health Clinical Center,Shanghai 201508,China;Department of Ultrasound,Zhongshan Hospital,Fudan University,Shanghai 200032,China)

机构地区：[1]上海市公共卫生临床中心超声科,上海201508 [2]复旦大学附属中山医院超声科,上海200032

出　　处：《肿瘤影像学》2020年第5期425-428,共4页Oncoradiology

基　　金：上海市科学技术委员会科研项目(18411970800)。

摘　　要：目的:探讨床旁超声对新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)的诊断价值。方法:回顾并分析2020年2月7日—2月29日上海市公共卫生临床中心收治的确诊为COVID-19的294例中的40例患者的临床资料及88次床旁超声检查结果。结果:40例患者中,男性、女性各20例,年龄为25~82岁,平均年龄62.2岁;腹部超声检查12例,发现脂肪肝5例,肝硬化脾肿大1例,肝形态失常1例,胆囊结石、息肉各1例,胆汁淤积5例,双肾结石、左肾轻度积水、前列腺增生1例;对20例患者行心脏超声检查43次,静息状态下超声心动图未见明显异常5例,其余15例均有不同程度的基础心脏疾病及患病后心脏病变,如左室舒张功能减退11例、肺动脉高压3例,心包积液5例;外周血管检查14例,下肢深静脉血栓6例,下肢动脉斑块5例,下肢动静脉正常5例;40例患者进行了65次胸部肺超声检查,均发现多发大小不等的肺部病灶,其中胸腔积液19例。结论:应急病房床旁超声检查既可评估患者基础疾病状况,又能明确有无新型冠状病毒导致的全身多器官损害及诊疗期间的继发病变。Objective:To explore the value of bedside ultrasound for evaluation of disease status of patients with coronavirus disease 2019(COVID-19).Methods:From Feb.7 to Feb.29,2020,40 patients of the total 294 patients diagnosed with COVID-19 were admitted to Shanghai Public Health Clinical Center.The clinical data and ultrasound examination results of these patients were retrospectively collected and analyzed.Results:Of the 40 patients,20 males and 20 females,aged 25-82(mean 62.2)years.Twelve abdominal ultrasound examinations revealed:5 fatty liver,1 cirrhosis,1 splenomegaly,1 liver morphology abnormality,1 gallbladder stones and 1 gallbladder polyps,5 cholestasis,1 double kidney stones,mild left hydrocephalus and benign prostatic hyperplasia;Forty-three cardiac echocardiography examinations in 20 patients revealed 15 cases with varying degrees of basic heart disease or heart disease after illness,including 11 left ventricular diastolic dysfunction,3 pulmonary hypertension,and 5 pericardial effusion;the other 5 cases had no obvious abnormalities in resting state.Peripheral blood vessel examinations in 14 patients revealed:6 vein thrombosis and 5 arterial plaque in lower limbs,respectively;the other 5 cases showed no abnormalities in arteriovenous veins of lower limbs.Sixty-five chest and lung ultrasound examinations were performed in all forty patients,and multiple lung lesions of various sizes were detected,and 19 pleural effusion were detected.Conclusion:Bedside ultrasound in the emergency ward is helpful in the assessment of underlying disease status and to determine whether there are systemic multiple organ damage and secondary lesions caused by novel coronavirus.

关 键 词：新型冠状病毒肺炎 超声 诊断 

分 类 号：R730.41[医药卫生—肿瘤] R445.1[医药卫生—临床医学]