重症超声对围术期突发心肺功能不全者的应用价值  

Application of critical care ultrasound in patients with sudden cardiopulmonary dysfunction during perioperative period

作　　者：赵丹 赵永法 万乐 刘涛[1] ZHAO Dan;ZHAO Yong-fa;WAN Le(Affiliated Hospital of Jiangxi University of Chinese Medicine,Nanchang 330000,China;Jiangxi University of Chinese Medicine,Nanchang 330000,China)

机构地区：[1]江西中医药大学附属医院,江西南昌330000 [2]江西中医药大学,江西南昌330000

出　　处：《吉林医学》2023年第11期3043-3046,共4页Jilin Medical Journal

基　　金：江西省卫生健康委科技计划项目[项目编号:202210745]。

摘　　要：目的:探讨重症超声对比常规监测手段在围术期患者突发急性呼吸困难或血流动力学不稳定等心肺功能不全情况病因诊断中的应用效果进行了比较及效果分析。方法:选取240例围术期突发急性呼吸困难或血流动力学不稳定等心肺功能不全患者为研究对象,随机分为对照组与试验组各120例,对照组行常规监测手段,试验组行肺部超声、心脏超声、血管超声检查,记录所有患者病因诊断结果;比较两组的诊断效能:平均初步诊断时间、确诊时间、初步对症治疗时间、诊断准确率、特异度及敏感度。结果:两组主要病因均为肺炎、低血容量性休克。对照组平均初步诊断时间(32.25±10.50)min,确诊时间(90.32±8.50)min,初步对症治疗时间(45.50±6.32)min,诊断准确率79.17%,特异度70.83%,敏感度75.00%;试验组平均初步诊断时间(15.25±6.72)min,确诊时间(72.78±11.45)min,初步对症治疗时间(36.84±11.37)min,诊断准确率91.67%,特异度95.00%,敏感度86.67%。结论:对于围术期突发急性呼吸困难或血流动力学不稳定患者而言,重症超声比常规监测手段更具有优势,包括重症超声诊断病因所需时间更短,初步诊断时间与确诊时间短,且诊断准确率较高,采用初步对症治疗的时间更短,特异度及敏感度相对较高,对提高围术期患者救治成功率有帮助作用。Objective The application effect of severe ultrasound compared with conventional monitoring methods in the etiological diagnosis of cardiopulmonary insufficiency such as sudden acute dyspnea or hemodynamic instability in perioperative patients was compared and analyzed.Method A total of 240 patients with cardiopulmonary insufficiency such as sudden acute dyspnea or hemodynamic instability during the perioperative period in our hospital were selected as the research object,and randomly divided into 120 cases in the control group and 120 cases in the experimental group,the control group underwent routine monitoring methods,the experimental group underwent lung ultrasound,cardiac ultrasound,vascular ultrasound,and recorded the etiological diagnosis results of all patients.The diagnostic efficacy of the control group and the experimental group were compared:average initial diagnosis time,diagnosis time,initial symptomatic treatment time,diagnostic accuracy,specificity and sensitivity.Results The main causes of both groups were pneumonia and hypovolaemic shock.The average initial diagnosis time of the control group was(32.25±10.50)min,the diagnosis time was(90.32±8.50)min,the initial symptomatic treatment time was(45.50±6.32)min,the diagnostic accuracy was 79.17%,the specificity was 70.83%,the sensitivity was 75.00%,the average initial diagnosis time of the experimental group was(15.25±6.72)min,the diagnosis time was(72.78±11.45)min,and the preliminary symptomatic treatment time was(36.84±11.37)min.The diagnostic accuracy was 91.67%,the specificity was 95.00%,and the sensitivity was 86.67%.Conclusion For patients with perioperative sudden acute dyspnea or hemodynamic instability,critical care ultrasound has more advantages than conventional monitoring methods,including shorter time required for critical care ultrasound to diagnose the cause,short initial diagnosis time,short diagnosis time,and higher diagnostic accuracy,shorter time for initial symptomatic treatment,relatively high specificity and sensitivity,wh

关 键 词：重症超声 围术期 心肺功能不全 

分 类 号：R56[医药卫生—呼吸系统]