改良肺部超声检查法对新型冠状病毒肺炎痊愈患者肺部损害的随访评估  

Follow-up evaluation of pulmonary lesions in patients recovering from COVID-19 with improved pulmonary ultrasonography

作　　者：孙安毅 吕国荣 张颖 蒋燕成 戴凯峰[5] 康卓 黄艺君 Sun Anyi;Lyu Guorong;Zhang Ying;Jiang Yancheng;Dai Kaifeng;Kang Zhuo;Huang Yijun(Department of Ultrasound,Quanzhou First Hospital,Quanzhou 362000,China;Quanzhou Medical College,Quanzhou 362000,China;Department of Ultrasound,the Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China;Department of Laboratory Medicine,Quanzhou First Hospital,Quanzhou 362000,China;Department of Imaging,Quanzhou First Hospital,Quanzhou 362000,China)

机构地区：[1]泉州市第一医院超声科,362000 [2]泉州医学高等专科学校,362000 [3]福建医科大学附属第二医院超声科,泉州362000 [4]泉州市第一医院检验科,362000 [5]泉州市第一医院影像科,362000

出　　处：《中华超声影像学杂志》2021年第5期392-396,共5页Chinese Journal of Ultrasonography

摘　　要：目的评估改良肺部超声检查法对新型冠状病毒肺炎(corona virus disease 2019,COVID-19)痊愈患者肺部损害的随访作用。方法随机选取2020年1-5月泉州市第一医院22例COVID-19痊愈患者,按照入院首次高分辨率CT(high resolution CT,HRCT)检查分为轻度7例、中度12例、重度3例。痊愈后6个月前瞻性地采用改良肺部超声检查法和HRCT对肺部损害进行评估,评价改良肺部超声检查法与HRCT检查的相关性和一致性。结果①治愈后6个月,轻度组肺部损害与中度组、重度组差异有统计学意义(均P<005),而中度组与重度组差异无统计学意义(P>005)。②改良肺部超声检查法与HRCT具有较高的一致性(Kappa=0776,P<0001)。③改良肺部超声检查法评分与HRCT Warrick评分之间呈正相关(r=0755,P<0001)。结论改良肺部超声检查法可作为COVID-19痊愈患者评估肺部损害随访的优先检查方案,以减少CT使用,为临床进一步诊治提供有利的证据。Objective To evaluate the value of improved pulmonary ultrasonography in the follow-up assessment of lung damage in patients who recovered from corona virus disease 2019(COVID-19).Methods Twenty-two patients who were cured of COVID-19 in Quanzhou First Hospital from January to May 2020 were randomly selected and divided into 7 mild cases,12 moderate cases and 3 severe cases according to the first high-resolution CT(HRCT)at admission.Six months after recovery,modified lung ultrasonography and HRCT were used prospectively to assess the lung damage and evaluate the correlation and consistency between the two techniques.Results①There were significant differences in lung damage between the mild group and the moderate group,severe group(all P<0.05),while there was no significant difference between the moderate group and severe group(P>0.05).②There was good consistency between the improved lung ultrasound examination and HRCT(Kappa=0.776,P<0.001).③There was a positive correlation between the score of improved pulmonary ultrasound examination and HRCT Warrick score(r=0.755,P<0.001).Conclusions Improved pulmonary ultrasonography can be used as a priority in the evaluation of pulmonary damage follow-up in patients with COVID-19 recovery,reducing the use of CT,and providing favorable evidence for further clinical management.

关 键 词：超声检查 新型冠状病毒肺炎 高分辨率CT 随访 肺间质纤维化 

分 类 号：R563.1[医药卫生—呼吸系统]