摘要
目的:探讨重症监护病房(ICU)应用床旁超声对多发性创伤合并胸部损伤患者的诊断价值。方法:选取我院ICU救治的100例多发伤且怀疑合并胸部损伤的患者进行研究,收集时间2016-02—2017-02期间所有患者均由我院经过专业培训的医生进行床旁超声检查,并于检查后2h内接受胸部CT、胸片检查,以临床最终确诊结果作为金标准,计算床旁超声在鉴别诊断胸部损伤中的价值。结果:100例多发伤疑似合并胸部损伤患者最终临床确诊77例患者合并胸部损伤,其中合并气胸13例,合并胸腔积液50例,合并肺挫伤28例,合并心包积液6例,合并创伤性膈疝2例;床旁超声诊断与临床确诊结果的符合率:气胸84.62%,胸腔积液94.00%,肺挫伤82.14%,心包积液100.00%,创伤性膈疝50.00%,其诊断结果与CT诊断结果的符合率比较,差异无统计学意义(P>0.05);床旁超声在气胸、胸腔积液、肺挫伤、心包积液中的诊断符合率显著高于胸片检查(P<0.05);床旁超声平均耗时显著的低于CT及胸片检查(P<0.05),CT平均耗时显著的低于胸片检查(P<0.05);床旁超声鉴别诊断胸部损伤的灵敏度为88.31%,特异度为91.30%,漏诊率为11.69%,误诊率为8.70%;CT鉴别诊断胸部损伤的灵敏度为96.10%,特异度为95.65%,漏诊率为3.90%,误诊率为4.35%;胸片鉴别诊断胸部损伤的灵敏度为76.62%,特异度为73.91%,漏诊率为23.38%,误诊率为26.09%。结论:ICU应用床旁超声对多发性创伤合并胸部损伤患者的诊断具有耗时短、诊断符合率高的优势。
Objective：To explore the diagnostic value of bedside ultrasound in ICU（ICU）for patients with multiple trauma and chest injury.Method：Selection of ICU in our hospital treatment of 100 cases of multiple trauma and suspected of combined thoracic injury were collected from February 2016 to February 2017,the time,all the patients were from our hospital trained doctors bedside ultrasound,chest X-ray,chest CT and accept the check to check within 2 hafter the clinical final diagnosis as a result the gold standard,the calculation of bedside ultrasound in differential diagnosis of chest injury in value.Result：One hundred cases of multiple trauma patients with suspected chest injury confirmed 77 cases of patients with clinical chest injury,including 13 cases of pneumothorax and pleural effusion in 50 cases,28 cases with pulmonary contusion,6 cases with pericardial effusion,2 cases with traumatic diaphragmatic hernia;bedside ultrasound diagnosis and clinical diagnosis results：the coincidence rate of pneumothorax 84.62%,pleural effusion in 94.00%,pulmonary contusion,82.14% pericardial effusion,100.00% traumatic diaphragmatic hernia in 50.00%,with the result of diagnosis and CT diagnosis results the rate difference was not statistically significant（P〈0.05）;bedside ultrasound in diagnosis of pneumothorax,pleural effusion fluid,pulmonary contusion,pericardial effusion in the chest radiograph（coincidence rate was significantly higher than that of P〈0.05）;the average time of bedside ultrasound and chest X-ray examination is significantly lower than the CT（P〈0.05）CT,the average time is significantly lower than the chest radiograph（P〈0.05）;bedside ultrasound diagnosis The sensitivity of chest injury was 88.31%,the specificity was 91.30%,the misdiagnosis rate was11.69%,the misdiagnosis rate was 8.70%;the sensitivity of CT in differential diagnosis of chest injury was96.10%,the specificity was 95.65%,the misdiagnosis rate was 3.90%,the misdiagnosis rate was 4.35%;the sensitivity of chest X-ray differential diagnosis of chest injury was 76.62%,the specificity was 73.91%.The misdiagnosis rate was 23.38%,the misdiagnosis rate was 26.09%.Conclusion：ICU bedside ultrasound has the advantages of short time and high diagnostic accuracy in the diagnosis of multiple trauma patients with chest injury.
作者
陈建军
邓义军
王琦
何应丰
CHENG Jianjun;DENG Yijun;WANG Qi;HE Yingfeng(Department of Severe Medicine,Yancheng First People＇s Hospital,Jiangsu,Yancheng,276800,Chin)
出处
《临床急诊杂志》
CAS
2018年第4期221-224,共4页
Journal of Clinical Emergency
基金
2017盐城市卫生医学科技发展计划项目(No:YK2017008)
作者简介
通信作者：邓义军，E-mail：dengyj2003@163．com
