改良BLUE方案肺超声评分在机械通气患者中的应用价值  

The value of modified BLUE scheme lung ultrasound score in patients with mechanical ventilation

作　　者：秦桂香 储鑫 吕学东[2] 朱保锋[1] 陈建荣[1] QIN Guixiang;CHU Xin;LüXue-dong;ZHU Bao-feng;CHEN Jian-rong(Department of Emergency,The Second Affiliated Hospital of Nantong University,Nantong 226001,Jiangsu,China;Department of Respiratory and Critical Care,The Second Affiliated Hospital of Nantong University,Nantong 226001,Jiangsu,China)

机构地区：[1]南通大学第二附属医院急诊科,江苏南通226001 [2]南通大学第二附属医院呼吸与危重症医学科,江苏南通226001

出　　处：《生物医学工程与临床》2024年第3期348-353,共6页Biomedical Engineering and Clinical Medicine

基　　金：南通市科技局重点项目(HS2018002);南通市科技局社会民生科技公众健康重点项目(MS22020010);南通市卫生健康委员会(QA2021017)。

摘　　要：目的比较改良BLUE方案肺超声评分与传统区域评分法在机械通气患者中的应用优劣,探讨改良BLUE方案与序贯器官衰竭评估(SOFA)评分、氧合指数(OI)的相关性及其对机械通气患者预后评估的价值。方法选择南通大学第二附属医院急诊医学科行机械通气的危重症患者66例,其中男性45例,女性21例;年龄35~95岁,平均年龄72.11岁;病程2~37 d,平均病程12.03 d;疾病类型:肺炎、感染性休克等感染相关19例,心力衰竭16例,慢性阻塞性肺疾病急性发作呼吸衰竭15例,心肺复苏后11例,间质性肺炎2例,中毒2例,外伤1例。根据患者的转归情况(28 d生存或死亡)分为好转组28例与死亡组38例。分别使用改良BLUE方案、4分区、6分区、8分区及12分区评分方法对患者进行肺部超声检查,以12分区评分为对照,分别比较改良BLUE方案、4分区、6分区、8分区超声评分与12分区评分结果的相关性。记录各检查方案检查时间,比较各评分法耗时差异。分析改良BLUE方案与SOFA评分和OI的相关性。比较两组改良BLUE方案肺超声评分差异。结果在机械通气患者中,改良BLUE方案、4分区、6分区、8分区超声评分结果,均与12分区法评分结果呈正相关(r=0.98、0.94、0.96、0.95,P均<0.05),其中改良BLUE方案肺超声评分与12分区评分相关性最高。改良BLUE方案、4分区、6分区、8分区及12分区肺超声检查操作时间分别为(5.86±0.76)min、(4.86±0.71)min、(6.79±0.88)min、(8.18±1.02)min、(11.79±1.45)min,改良BLUE方案较6分区、8分区及12分区操作时间短(P均<0.05)。改良BLUE方案肺超声评分与OI呈负相关,与SOFA评分呈正相关(r=-0.42、0.25)。好转组与死亡组改良BLUE方案肺超声评分平均值分别为(12.04±5.87)分、(15.79±5.94)分。好转组改良BLUE方案肺超声评分明显低于死亡组,差异有统计学意义(P<0.05)。结论在机械通气危重症患者中,使用改良BLUE方案肺超声评分具有准确�Objective To compare the application of modified BLUE scheme lung ultrasound score and traditional regional score in patient with mechanical ventilation,and probe the correlation between modified BLUE scheme and sequential organ failure assessment(SOFA)score,oxygenation index(OI)and its prognostic value in patient with mechanical ventilation.Methods A total of 66 critically ill patients performed mechanical ventilation were enrolled,which included 45 males and 21females,aged 35-95 years old with mean age of 72.11 years old;disease duration 2-37 days with mean duration of12.03 days.There were 19 cases of pneumonia and septic shock infection,16 of heart failure,15 of acute respiratory failure of chronic obstructive pulmonary disease,11 of complete cardiopulmonary resuscitation,2 of interstitial pneumonia,2 of poisoning and 1 of trauma.According to patient outcome(28-day survival or death),all of them were divided into improvement group(n=28)and death group(n=38).The modified BLUE scheme,4-zone,6-zone,8-zone and 12-zone scoring methods were used to perform lung ultrasound examination.The 12-zone score was used as control,and correlation with ultrasound scores of modified BLUE scheme,4-zone,6-zone,8-zone and 12-zone scoring methods was compared.The examination time of each scheme was recorded,and the time-consuming differences of each scoring method were compared.The correlation between modified BLUE scheme and SOFA score and OI was analyzed.The difference of lung ultrasound score between 2 groups was compared.Results In patient with mechanical ventilation,the ultrasound scores of modified BLUE scheme,4-zone,6-zone and 8-zone were all positively correlated with results of 12-zone method(r=0.98,0.94,0.96,0.95,P<0.05),and the correlation between modified BLUE scheme and 12-zone score was the highest.The lung ultrasound examination time of modified BLUE scheme,4-zone,6-zone,8-zone and 12-zone were(5.86±0.76)minutes,(4.86±0.71)minutes,(6.79±0.88)minutes,(8.18±1.02)minutes and(11.79±1.45)minutes,respectively.The exam

关 键 词：肺超声 肺超声评分 改良BLUE方案 机械通气 

分 类 号：R459.7[医药卫生—急诊医学] R445.1[医药卫生—治疗学]