重症急会诊超声流程在急性呼吸困难病因诊断中的应用  

Application of critical consultation ultrasonic examination in etiological diagnosis of acute dyspnea

作　　者：丛锋 CONG Feng(Intensive Care Unit,Panjin Central Hospital,Panjin,Liaoning,124000,China)

机构地区：[1]盘锦市中心医院重症医学科,辽宁盘锦124000

出　　处：《当代医学》2022年第12期5-9,共5页Contemporary Medicine

摘　　要：目的重症急会诊超声流程(CCUE)在急性呼吸困难病因诊断中的应用。方法回顾性分析2019年6月至2020年6月盘锦市中心医院重症医学科(ICU)收治的46例急性呼吸困难患者的临床资料,患者均进行常规检查及CCUE检查。比较两种检查方式初步诊断时间、确定诊断时间、开启治疗时间、诊断准确率,及应用CCUE检查法的敏感度、特异度。结果46例患者中男27例,女19例;平均年龄(58.2±16.4)岁;平均急性生理学及慢性健康状况评分系统评分(APACHEⅡ)(21.5±8.1)分。急性呼吸困难病因:心源性肺水肿9例,急性呼吸窘迫综合征(ARDS)3例,肺炎10例,气胸3例,肺栓塞2例,胸腔积液5例,慢性阻塞性肺疾病急性加重期(AECOPD)/哮喘14例,CCUE检查法确诊准确率均高于常规检查法。CCUE检查法初步诊断时间、确定诊断时间、开启治疗时间短低于常规检查法,差异有统计学意义(P<0.05)。CCUE检查法诊断心源性肺水肿敏感度为91.3%,特异度为92.7%;ARDS敏感度为90.5%,特异度为88.3%;肺炎敏感度为85.4%,特异度为95.3%;AECOPD/哮喘敏感度为82.2%,特异度为84.6%。结论对于收入ICU的急性呼吸困难患者应用CCUE检查法可快速、准确地判断急性呼吸困难的病因,缩短对症治疗时间。Objective The application of critical consultation ultrasonic examination(CCUE)in the etiological diagnosis of acute dyspnea.Methods The clinical data of 46 patients with acute dyspnea admitted to the Intensive Care Unit(ICU)of Panjin Central Hospital from June 2019 to June 2020 were retrospectively analyzed.All patients underwent routine examination and CCUE examination.The initial diagnosis time,confirmed diagnosis time,treatment initiation time,diagnostic accuracy were compared between two examination methods,and the sensitivity and specificity of CCUE examination method.Results Among the 46 patients,there were 27 males and 19 females;the mean age was(58.2±16.4)years;the mean acute physiology and chronic health evaluation scoring system(APACHE II)score was(21.5±8.1).Causes of acute dyspnea:9 cases of cardiogenic pulmonary edema,3 cases of acute respiratory distress syndrome(ARDS),10 cases of pneumonia,3 cases of pneumothorax,2 cases of pulmonary embolism,5 cases of pleural effusion,2 cases of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)/asthma,the accuracy rate of CCUE examination method was higher than that of routine examination method.The initial diagnosis time,confirmed diagnosis time and treat-ment initiation time of CCUE inspection method were all lower than those of routine examination method,and the difference was statistically signifi-cant(P<0.05).The sensitivity and specificity of CCUE examination for the diagnosis of cardiogenic pulmonary edema were 91.3%and 92.7%;for ARDS,the sensitivity was 90.5%and the specificity was 88.3%;for pneumonia,the sensitivity was 85.4%and the specificity was 95.3%;AECOPD/asthma The sensitivity was 82.2%and the specificity was 84.6%.Conclusion For patients with acute dyspnea admitted to ICU,CCUE examination can quickly and accurately determine the etiology of acute dyspnea,and shorten the time of sympto matic treatment.

关 键 词：重症超声 急性呼吸困难 重症急会诊超声流程 

分 类 号：R563.8[医药卫生—呼吸系统]