CLAUS与POCURM在急性呼吸困难病因诊断中的对比研究  

Comparison of CLAUS and POCURM in the etiological diagnosis of acute respiratory distress

作　　者：肖飞龙 程江华[1] 丁颖威 毛云 XIAO Feilong;CHENG Jianghua;DING Yingwei;MAO Yun(Department of Emergency,Jinhua City Central Hospital,Jinhua 321000,Zhejiang,China)

机构地区：[1]金华市中心医院急诊科,浙江金华321000

出　　处：《中国现代医生》2025年第8期21-23,32,共4页China Modern Doctor

基　　金：浙江省金华市科技计划项目(2021-3-075)。

摘　　要：目的探讨联合心肺及附加超声(cardiopulmonary and additional ultrasound,CLAUS)方案与床旁超声快速管理(point-of-care ultrasound rapid management,POCURM)方案在急诊室重症患者急性呼吸困难病因诊断中的价值。方法选取2022年1月至2024年1月金华市中心医院收治的242例急性呼吸困难患者为研究对象,根据出院最终诊断分为心源组(n=144)和肺源组(n=98)。比较两组患者的CLAUS结果及两种方案诊断急性呼吸困难病因的准确性。结果心源组患者的心脏疾病史比例高于肺源组,心源组患者的肺部疾病史比例低于肺源组,差异有统计学意义(P<0.05)。心源组患者的胸膜光滑/稍增厚、滑动存在/稍减弱比例与左心功能不全、右心功能不全和肺部超声B线评分均高于肺源组患者,差异有统计学意义(P<0.05)。POCURM方案诊断急性呼吸困难病因的敏感度为90.28%,特异性为91.84%;CLAUS方案诊断急性呼吸困难病因的敏感度为96.53%,特异性为97.96%。结论CLAUS方案可有效诊断急性呼吸困难患者的具体病因,其准确率高于POCURM方案。Objective To explore the value of cardiopulmonary and additional ultrasound(CLAUS)protocol and point-of-care ultrasound rapid management(POCURM)protocol in etiological diagnosis of acute respiratory distress in critically ill patients in the emergency room.Methods A total of 242 patients with acute respiratory distress admitted to Jinhua City Central Hospital from January 2022 to January 2024 were selected as the research subjects.According to the final diagnosis after discharge,they were divided into cardiogenic group(n=144)and pulmonary group(n=98).Compare the CLAUS findings of two groups and accuracy of two protocols in diagnosing etiology of acute respiratory distress.Results The history of heart disease in cardiogenic group was higher than that in pulmonary group,and difference was statistically significant(P<0.05).The lung disease history of patients in cardiogenic group was lower than that in pulmonary group,and difference was statistically significant(P<0.05).The proportion of pleural smoothness/slight thickening,sliding presence/slight weakening,left heart dysfunction,right heart dysfunction,and B-line pulmonary ultrasound scores in cardiogenic group were higher than those in pulmonary group,and differences were statistically significant(P<0.05).The sensitivity,specificity of POCURM protocol for diagnosing acute respiratory distress were 90.28%,91.84%.The sensitivity,specificity of CLAUS protocol for diagnosing acute respiratory distress were 96.53%,97.96%.Conclusion CLAUS regimen can effectively diagnose specific causes of acute respiratory distress in patients,with higher accuracy than POCURM regimen.

关 键 词：急性呼吸困难 急诊室重症 床旁超声快速管理 

分 类 号：R441.8[医药卫生—诊断学]