肺超声与胸部X线对儿童急性肺创伤的诊断价值比较  

Diagnostic accuracy of ultrasonography and radiography in children with acute chest trauma

作　　者：陈伟玲[1] 夏焙[1] 林洲[1] 范舒旻[1] 何学智[1] 李志惠[1] Chen Weiling;Xia Bei;Lin Zhou;Fan Shumin;He Xuezhi;Li Zhihui(Department of Ultrasonography,Shenzhen Children Hospital,Shenzhen 518038,China)

机构地区：[1]深圳市儿童医院超声科,518038

出　　处：《中华超声影像学杂志》2021年第11期988-992,共5页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金面上项目(62071309)。

摘　　要：目的探讨肺超声与胸部X线在识别儿童急性胸部外伤性内脏损伤诊断中的价值。方法回顾性分析2017年1月至2021年1月于深圳市儿童医院收治的46例胸部外伤患儿。以胸部CT结果为金标准,分析比较肺超声和X线检查对儿童急性创伤血气胸、肺挫伤的诊断效能。结果肺超声诊断气胸、血胸和肺挫伤的敏感性分别为0.79、0.86、0.86,特异性分别为0.98、0.75、0.80。肺超声诊断气胸、血胸和肺挫伤的ROC曲线下面积分别为0.889(95%CI=0.798~0.979,P<0.001)、0.804(95%CI=0.707~0.901,P<0.001)和0.831(95%CI=0.623~1.000,P<0.001)。X线诊断气胸、血胸和肺挫伤的ROC曲线下面积分别为0.674(95%CI=0.544~0.803,P=0.008)、0.645(95%CI=0.517~0.772,P=0.026)和0.547(95%CI=0.289~0.805,P=0.724)。ROC曲线下面积的比较表明肺超声对气胸、血胸和肺挫伤的诊断优于X线平片(均P<0.05)。结论肺超声在初步评估胸部钝性创伤时比胸部X线有更高的敏感性和准确性。对于急性胸部钝性创伤患儿应优先考虑肺部超声检查。Objective To compare the diagnostic accuracy of lung ultrasonography and radiography in detection of acute traumatic intrathoracic injuries in children.Methods A retrospective analysis was performed in 46 cases of children with chest trauma in Shenzhen Children′s Hospital from January 2017 to January 2021.The diagnostic efficiency of lung ultrasound and radiography in children with acute traumatic hemopneumothorax and lung contusion were compared.Computed tomography scan was used as gold standard.Results The sensitivity and specificity of lung ultrasound were 0.79 and 0.98 for pneumothorax,0.86 and 0.75 for hemothorax,0.86 and 0.80 for pulmonary contusion,respectively.Area under the ROC curve of ultrasonography in detection of pneumothorax,hemothorax,and pulmonary contusion was 0.889(95%CI=0.798-0.979,P<0.001),0.804(95%CI=0.707-0.901,P<0.001),and 0.831(95%CI=0.623-1.000,P=0.013),respectively.Area under the ROC curve of radiography was 0.674(95%CI=0.544-0.803,P=0.008)for detection of pneumothorax,0.645(95%CI=0.517-0.772,P=0.026)for hemothorax,and 0.547(95%CI=0.289-0.805,P=0.724)for pulmonary contusion.Comparison of area under the ROC curve declared the significant superiority of ultrasonography in detection of pneumothorax,hemothorax and pulmonary contusion(all P<0.05).Conclusions Lung ultrasound has higher sensitivity and accuracy than chest radiography in the initial evaluation of chest trauma.For children with acute chest trauma,lung ultrasound should be the first choice.

关 键 词：超声检查 急诊 创伤 肺 

分 类 号：R445.1[医药卫生—影像医学与核医学] R725.6[医药卫生—诊断学]