基于早期肺部CT定量检测评估中重度ARDS患者预后的价值  

Value of Early Quantitative Lung CT in Evaluating the Prognosis of Moderatesevere ARDS

作　　者：王小雯[1] 郭丽纳 王会敏 郭海星 石文博 WANG Xiao-wen;GUO Li-na;WANG Hui-min;GUO Hai-xing;SHI Wen-bo(Department of Critical Care Medicine,Zhengzhou People's Hospital,Zhengzhou 450000,Henan Province,China)

机构地区：[1]郑州人民医院重症医学科,河南郑州450000

出　　处：《中国CT和MRI杂志》2025年第3期56-58,共3页Chinese Journal of CT and MRI

基　　金：2023年河南省医学科技攻关计划联合共建项目(LHGJ20230720)。

摘　　要：目的研究早期肺部计算机断层扫描(CT)定量检测对中重度急性呼吸窘迫综合征(ARDS)患者预后的评估价值。方法选取2019年3月至2024年3月于我院急诊重症监护室接收的80例ARDS患者为调查对象,根据急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分评估预后情况,并分为预后良好组与预后不良组,所有患儿均行肺部CT、动态连续监测血气分析,比较动脉血气水平[动脉氧分压(PaO_(2))/不改变吸入氧体积分数(FiO_(2))、呼气末正压通气(PEEP)]及APACHEⅡ评分,分析肺部CT在中重度ARDS患者预后评估中的价值。结果中度组PaO_(2)/FiO_(2)高于重度组,PEEP、APACHEⅡ评分低于重度组,差异有统计学意义(P<0.05);预后良好组PaO_(2)/FiO_(2)高于预后不良组,PEEP、APACHEⅡ评分低于预后不良组,差异有统计学意义(P<0.05);预后良好组肺部CT多呈磨玻璃阴影,无明显胸腔积液,而预后不良组肺部CT多表现为肺实变、弥漫性磨玻璃阴影,两组肺实变、胸腔积液、充气支气管征发生率比较差异有统计学意义(P<0.05)。结论早期肺部CT是评估ARDS的常见参考影像学技术,通过肺部CT特征分析联合动脉血气,共同辅助判断患者病情进展及预后情况。Objective To investigate the value of early quantitative lung computed tomography(CT)in evaluating the prognosis of moderate-severe acute respiratory distress syndrome(ARDS).Methods Eighty patients with ARDS who were admitted to emergency intensive care unit of the hospital from March 2019 to March 2024 were selected as the subjects.According to the Acute Physiology and Chronic Health Evaluation II(APACHE II)score,they were divided into the good prognosis group and the poor prognosis group.All patients underwent lung CT and dynamic continuous monitoring of blood gas.Arterial blood gas indices[partial pressure of oxygen(PaO_(2))/fraction of inspired oxygen(FiO_(2))ratio and positive end expiratory pressure(PEEP)]and APACHE II scores were compared.The value of lung CT in evaluating the prognosis of moderate-severe ARDS was analyzed.Results PaO_(2)/FiO_(2)ratio in the moderate group was higher than that in the severe group.PEEP and APACHE II scores were lower than those in the severe group(P<0.05).PaO_(2)/FiO_(2)ratio in the good prognosis group was higher than that in the poor prognosis group.PEEP and APACHE II scores were lower than those in the poor prognosis group(P<0.05).Lung CT of the good prognosis group showed ground-glass opacities and no obvious pleural effusion.Lung CT of the poor prognosis group showed lung consolidation and diffuse ground glass opacities.There were statistically significant difference in the incidence of lung consolidation,pleural effusion,and air bronchgram between the two groups(P<0.05).Conclusion Early lung CT is a common imaging technique for evaluating ARDS.Combining lung CT features with arterial blood gas analysis can assist in determining the progression and prognosis of ARDS.

关 键 词：早期肺部CT 中重度急性呼吸窘迫综合征 预后评估 

分 类 号：R56[医药卫生—呼吸系统]