新型冠状病毒肺炎患者肺部超声表现特征  

Lung ultrasound imaging features of patients with coronavirus disease-2019

作　　者：甘露 刘长珠[1] 林苑兰 李美瑜[1] 李翠芝[1] 张影[1] 林路平[1] GAN Lu;LIU Changzhu;LIN Yuanlan;LI Meiyu;LI Cuizhi;ZHANG Yin;LIN Luping(Guangzhou Eighth People’s Hospital,Guangzhou 510440,China;不详)

机构地区：[1]广州市第八人民医院,广东广州510440

出　　处：《现代医院》2020年第12期1869-1872,I0001,共5页Modern Hospitals

基　　金：广东省医学科研基金(A2019080);广州市科技计划项目(202002030235)。

摘　　要：目的分析新型冠状病毒肺炎患者肺部的超声表现特征。方法选择新型冠状病毒肺炎(COVID-19)确诊患者15例,其中普通型组9例、重型组6例,所有纳入的病例均行肺部超声检查并评分(Lung ultrasound score,LUS),总结分析COVID-19患者肺部超声图像特征。结果 15例COVID-19患者肺部超声均表现为异常,主要表现为多个肺区B线增多;融合B线或致密B线多出现在重症患者;3例(20%)患者出现肺实变,均为重型患者,表现为胸膜下的小片状实变,实变区边缘可见碎片征,普通型患者未见肺实变;4例患者(26.67%)出现胸膜线异常,表现为胸模线不规则增粗、模糊,重型患者胸模线可见连续性中断;所有患者均未见肺不张、胸腔积液、气胸超声表现。LUS评分:重型患者总LUS评分评分明显高于普通型患者,差异有统计学意义(P <0.01);重型组B1征象区、C征象区个数明显多于普通型组,差异有统计学意义(P <0.05);下肺LUS评分明显高于上肺LUS评分,差异有统计学意义(P <0.05);后肺LUS评分明显高于前肺LUS、侧肺LUS,差异有统计学意义(P <0.01)。结论 COVID-19普通型患者肺部超声表现特征主要表现为多灶性B线增多,胸模线不规则增粗、模糊;重型患者LUS评分明显高于普通型患者,肺部超声主要表现为B线明显增多且融合,可见胸膜下小片状肺实变,胸模线连续性中断。证明肺部超声检查能真实地反应COVID-19患者肺部病变情况,是病情评估和疗效判断的有效手段,可为临床诊疗提供有力的依据。Objective To analyze the ultrasound characteristics of the lungs of patients with new coronavirus pneumonia. Methods Fifteen patients diagnosed with novel coronavirus pneumonia( COVID-19) were selected,including 9 in the general group and 6 in the severe group. All included cases underwent lung ultrasound score( LUS),and summarized and analyzed COVID.-19 Characteristics of ultrasound images of the lungs of patients. Results The pulmonary ultrasound of 15 patients with COVID-19 showed abnormalities,mainly manifested as an increase in B-lines in multiple lung areas;fusion B-line or dense B-line mostly appeared in critically ill patients;3 cases( 20%) had lung consolidation,All patients were severe patients,manifested as small pieces of consolidation under the pleura,and fragments were seen at the edge of the consolidation zone. There was no lung consolidation in the ordinary patients;4 patients( 26. 67%) had abnormal pleural lines,manifested as chest mold lines Irregular thickening and blurring,and continuity of the chest mold line can be seen in severe patients;no atelectasis,pleural effusion,or pneumothorax were seen on ultrasound in all patients. LUS score: The total LUS score of severe patients was significantly higher than that of ordinary patients,and the difference was statistically significant( P < 0. 01);the number of B1 sign and C sign areas in the severe group was significantly more than that of the ordinary group,and the difference was statistically significant( P < 0. 05);the lower lung LUS score was significantly higher than the upper lung LUS score,the difference was statistically significant( P < 0. 05);the posterior lung LUS score was significantly higher than the front lung LUS and lateral lung LUS,the difference was statistically significant( P < 0. 01). Conclusion The characteristics of lung ultrasound in patients with COVID-19 are mainly manifested as multifocal increase in B-line,irregularly thickened and blurred chest pattern;LUS score of severe patients is significantly higher than that of o

关 键 词：新型冠状病毒肺炎 肺部超声 评分 

分 类 号：R511[医药卫生—内科学] R445.1[医药卫生—临床医学]