改良重症超声快速管理方案在心脏外科术后ICU患者低氧血症病因诊断中的应用研究  

Application of modified CCUE protocol in the etiological diagnosis ofhypoxemia in ICU patients after cardiac surgery

作　　者：韦树旺[1] 韦张旭 廖世锋[2] 韦珊珊[3] 韦柳江 兰婕燕 韦玉璇 谢玲玲[1] WEI Shuwang;WEI Zhangxu;LIAO Shifeng;WEI Shanshan;WEI Liujiang;LAN Jieyan;WEI Yuxuan;XIE Lingling(Department of Critical Care Medicine,The Third People’s Hospital of Hechi City,Hechi 547000,China)

机构地区：[1]河池市第三人民医院重症医学科,广西河池547000 [2]河池市第三人民医院心胸外科,广西河池547000 [3]河池市第三人民医院麻醉科,广西河池547000 [4]河池市第三人民医院超声科,广西河池547000

出　　处：《陕西医学杂志》2025年第1期93-96,共4页Shaanxi Medical Journal

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20190575)。

摘　　要：目的:探讨改良重症超声快速管理方案(M-CCUE)在心脏外科术后重症监护室(ICU)患者低氧血症病因诊断中的应用。方法:选择86例转入ICU低氧血症患者,采用M-CCUE方案进行病因分析,并与最终诊断结果进行匹配,对比分析M-CCUE方案诊断效能。结果:86例常规检查诊断肺水肿30例,胸腔积液17例,肺实变/肺不张25例,气胸12例。经M-CCUE方案诊断肺水肿33例,胸腔积液16例,肺实变/肺不张26例,气胸11例。进一步评估,最终确诊肺水肿34例,胸腔积液16例,肺实变/肺不张26例,气胸10例。常规检查对气胸诊断特异度为92.10%,灵敏度为60.00%,肺水肿诊断特异度为84.61%,灵敏度为64.70%,对胸腔积液、肺实变/肺不张诊断灵敏度均为超过60.00%。M-CCUE方案对胸腔积液、肺实变/肺不张、气胸诊断的特异度、灵敏度均高于80.00%。结论:M-CCUE方案对心脏外科术后低氧血症患者病因诊断灵敏度、特异度较高。Objective:To explore the application of improved rapid ultrasound management mode in the etiology diagnosis of hypoxemia in ICU patients after cardiac surgery.Methods:A total of 86 patients with hypoxemia admitted to ICU were selected,and the M-CCUE protocol was used to analyze the etiology and match the final diagnosis results,and the diagnostic efficacy of the M-CCUE protocol was compared and analyzed.Results:In 86 cases,30 cases of pulmonary edema,17 cases of pleural effusion,25 cases of lung consolidation/atelectasis,12 cases of pneumothorax were diagnosed by routine examination.M-CCUE protocol diagnosed 33 cases of pulmonary edema,16 cases of pleural effusion,26 cases of lung consolidation/atelectasis,11 cases of pneumothorax.Further evaluation confirmed 34 cases of pulmonary edema,16 cases of pleural effusion,26 cases of lung consolidation/atelectasis,and 10 cases of pneumothorax.The diagnostic specificity of routine examination for pneumothorax was 92.10%and sensitivity was 60.00%,the diagnostic specificity for pulmonary edema was 84.61%and sensitivity was 64.70%,and the diagnostic sensitivity for pleural effusion and pulmonary compactness/atelectasis was more than 60.00%.The specificity and sensitivity of M-CCUE protocol in the diagnosis of pleural effusion,lung compactness/attasis and pneumothorax are higher than 80.00%.Conclusion:M-CCUE protocol has high sensitivity and specificity in the etiological diagnosis of patients with hypoxemia after cardiac surgery,and is worthy of clinical promotion.

关 键 词：改良重症超声快速管理方案 超声 心脏手术 ICU 低氧血症 

分 类 号：R654.2[医药卫生—外科学]