床旁心肺超声对肺水肿或肺炎所致急性呼吸困难的鉴别诊断价值  

The Diagnostic Value of Bedside Cardiopulmonary Ultrasound to Identifying Acute Dyspnea Due to Pulmonary Edema or Pneumonia

作　　者：刘学琳 高佳宇 张建蕾[1] 刘江云[1] LIU Xuelin;GAO Jiayu;ZHANG Jianlei(Department of Ultrasound Diagnosis,Yan'an People's Hospital,Yan'an Shaanxi 716000)

机构地区：[1]延安市人民医院超声诊断科,陕西延安716000

出　　处：《医学临床研究》2024年第8期1202-1204,1208,共4页Journal of Clinical Research

摘　　要：【目的】探讨床旁心肺超声对肺水肿或肺炎引起的急性呼吸困难的鉴别诊断价值。【方法】选取2021年6月至2023年6月在本院就诊的152例急性呼吸困难患者,以胸部CT为诊断金标准,其中68例为肺水肿所致急性呼吸困难,84例为肺炎所致急性呼吸困难,所有患者均行常规检查和床旁心肺超声检查。统计常规检查、床旁心肺超声对肺水肿或肺炎所致急性呼吸困难的检测结果,采用Kappa检验分析常规检查、床旁心肺超声与胸部CT诊断的符合情况,比较常规检查与床旁心肺超声对肺水肿或肺炎引起急性呼吸困难的鉴别诊断价值。【结果】常规检查及床旁心肺超声费用比较,差异无统计学意义(P>0.05),床旁心肺超声检查时间明显短于常规检查(P<0.05)。床旁心肺超声诊断肺水肿或肺炎所致急性呼吸困难的总符合率为84.21%,高于常规检查的75.00%(χ^(2)=3.971,P=0.046),经Kappa一致性检验,Kappa=0.625、0.731。常规检查及床旁心肺超声鉴别诊断肺水肿或肺炎所致急性呼吸困难的AUC分别为0.709、0.805,联合检查鉴别诊断肺水肿或肺炎所致急性呼吸困难的AUC为0.923。【结论】床旁心肺超声对肺水肿或肺炎所致急性呼吸困难具有一定的鉴别诊断价值,其中常规检查联合床旁心肺超声对肺水肿或肺炎所致急性呼吸困难的鉴别诊断价值较高。【Objective】To evaluate the value of bedside cardiopulmonary ultrasound in differential diagnosis of acute dyspnea caused by pulmonary edema or pneumonia.【Methods】A total of 152 patients with acute dyspnea treated in our hospital from June 2021 to June 2023 were selected,and chest CT was used as the diagnostic gold standard.Among them,68 patients had acute dyspnea due to pulmonary edema and 84 patients had acute dyspnea due to pneumonia.Routine examination and bedside cardiopulmonary ultrasound were performed for all patients.The detection results of routine examination and bedside cardiopulmonary ultrasound for acute dyspnea caused by pulmonary edema or pneumonia were collected.Kappa test was used to analyze the consistency of routine examination,bedside cardiopulmonary ultrasound and chest CT diagnosis,and the differential diagnosis value of routine examination and bedside cardiopulmonary ultrasound for acute dyspnea caused by pulmonary edema or pneumonia was compared.【Results】There was no significant difference in the cost of between routine examination and bedside cardiopulmonary ultrasound(P>0.05),and the time of bedside cardiopulmonary ultrasound was significantly shorter than that of routine examination(P<0.05).The total coincidence rate of bedside cardiopulmonary ultrasound in diagnosing acute dyspnea caused by pulmonary edema or pneumonia was 84.21%,which was higher than that of routine examination(75.00%)(χ^(2)=3.971,P=0.046).Furthermore,Kappa consistency test showed that Kappa=0.625 and 0.731.The AUC for differential diagnosis of acute dyspnea caused by pulmonary edema or pneumonia with routine examination and bedside cardiopulmonary ultrasound was 0.709 and 0.805,respectively.The AUC for differential diagnosis of acute dyspnea caused by pulmonary edema or pneumonia in combination of both routine examination and bedside cardiopulmonary ultrasound was 0.923.【Conclusion】Bedside cardiopulmonary ultrasound has a certain diagnostic value in the differential diagnosis of acute dyspnea caused

关 键 词：呼吸困难/影像诊断 急性病 超声检查 肺水肿 肺炎 

分 类 号：R441.8[医药卫生—诊断学]