以肺部超声为应用的多学科诊疗体系在高原性肺水肿诊疗中的价值  

Value of a Diagnosis and Treatment System Based on Pulmonary Ultrasound for High-Altitude Pulmonary Edema

作　　者：袁灵[1] 钟静怡 江兵 熊明[4] 虞莲会[1] 康厚乐 钟武 Yuan Ling;Zhong Jingyi;Jiang Bing;Xiong Ming;Yu Lianhui;Kang Houle;Zhong Wu(Luzhou People's Hospital,Luzhou 646000,China;Luzhou City Longmatan District Center for Disease Control and Prevention,Luzhou 646000,China;Daocheng County People's Hospital of Ganzi Prefecture,Ganzi 627750,China;Sichuan University West China Guang'an People's Hospital,Guang'an 638500,China;Sichuan Provincial Bayi Rehabilitation Hospital,Chengdu 611100,China)

机构地区：[1]泸州市人民医院,泸州646000 [2]泸州市龙马潭区疾病预防控制中心,泸州646699 [3]甘孜州稻城县人民医院,甘孜627750 [4]四川大学华西广安市人民医院,广安638500 [5]四川省八一康复医院,成都611100

出　　处：《成都医学院学报》2024年第1期94-97,104,共5页Journal of Chengdu Medical College

基　　金：四川省医学会医学科研青年创新基金(No:Q17043);泸州市财政局科技计划科研项目(No:2017s-47)。

摘　　要：目的探索以肺部超声为应用的多学科诊疗体系在高原性肺水肿诊疗中的价值。方法选取2018—2022年在甘孜州稻城县人民医院急诊科收治的200例疑似高原性肺水肿患者为研究对象,将其中确诊的115例患者按照平衡序贯法随机分为试验组(采用以肺部超声为应用的多学科诊疗体系,n=56)和对照组(采用常规诊疗方式,n=59),比较两组的诊疗效果。结果在早期诊断高原性肺水肿中,肺部超声的灵敏度、正确指数及阴性预测值均高于X线检查结果(P<0.05),而与CT检查结果比较差异无统计学意义(P>0.05)。试验组的诊疗时效性、抗生素使用率、心衰发生率、无创呼吸机上机率、康复期恢复等方面优于对照组(P<0.05)。结论以肺部超声为应用的多学科诊疗体系在高原性肺水肿早期诊断中具有较高的灵敏度、正确指数及阴性预测值,可促进患者愈后及康复。Objective To explore the value of a diagnosis and treatment system based on pulmonary ultrasound in the diagnosis and treatment of high-altitude pulmonary edema(HAPE).Methods Patients with suspected HAPE admitted to the emergency department of Daocheng County People's Hospital of Ganzi Prefecture from 2018 to 2022 were selected as the study objects.Among them,115 patients with confirmed HAPE were randomly divided into an experimental group(diagnosis and treatment system based on pulmonary ultrasound,n=56)and a control group(conventional diagnosis and treatment method,n=59)according to a balanced sequential method.The clinical improvement was compared between the two groups.Results In the early diagnosis of HAPE,the sensitivity,accuracy index,and negative predictive value of pulmonary ultrasound were higher than those of X-ray examination(P<0.05),but there was no statistically significant difference in the examination results between pulmonary ultrasound and computed tomography(CT)(P>0.05).The timeliness of diagnosis and treatment,defined daily dose system(DDDs)of antibiotic use,incidence of heart failure,non-invasive ventilator use rate,and recovery during rehabilitation period in the experimental group were all better than those in the control group(P<0.05).Conclusion The diagnosis and treatment system based on pulmonary ultrasound has high sensitivity,accuracy index,and negative predictive value in the diagnosis and treatment of HAPE,which can promote the recovery of patients.

关 键 词：高原性肺水肿 肺部超声 诊疗体系 

分 类 号：R179[医药卫生—妇幼卫生保健]