有症状的非创伤性胸腔积液的急诊超声评估

Emergency ultrasound evaluation of symptomatic nontraumatic pleural effusions.

作者信息

Tayal Vivek S, Nicks Bret A, Norton H James

机构信息

Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC 28232, USA.

出版信息

Am J Emerg Med. 2006 Nov;24(7):782-6. doi: 10.1016/j.ajem.2006.03.017.

DOI:10.1016/j.ajem.2006.03.017

PMID:17098097

Abstract

OBJECTIVE

We hypothesized that thoracic ultrasound (ThorUS) performed by emergency physicians would be a rapid and effective management tool for the evaluation of nontraumatic pleural effusion (PleurEff).

METHODS

This is a prospective observational study of symptomatic adults presenting to an urban ED with suspicion of PleurEff. ThorUS was performed bilaterally in the upright position. Measurements included treating physician's procedural time requirements, pre- and posttest likelihood of PleurEff, and management changes.

RESULTS

There were 59 patients who were entered into the study. Investigating physician's actual time to perform ThorUS was 2.19 minutes. After ThorUS, 48 (81%) patients had an increase and 11 (19%) had a reduction in likelihood of PleurEff with average absolute change in likelihood of PleurEff of 34% (P < .02). ThorUS changed management in 41% of cases; thoracentesis occurred most frequently.

CONCLUSION

ThorUS performed by emergency physicians is a rapid and effective management tool for the evaluation of nontraumatic PleurEff in symptomatic ED patients.

摘要

目的

我们假设急诊医生进行的胸部超声（ThorUS）将是评估非创伤性胸腔积液（PleurEff）的一种快速有效的管理工具。

方法

这是一项对因疑似PleurEff而就诊于城市急诊科的有症状成年人进行的前瞻性观察性研究。在直立位双侧进行ThorUS检查。测量内容包括主治医生的操作时间要求、检查前后PleurEff的可能性以及管理措施的变化。

结果

共有59例患者纳入研究。检查医生进行ThorUS的实际时间为2.19分钟。ThorUS检查后，48例（81%）患者PleurEff的可能性增加，11例（19%）患者PleurEff的可能性降低，PleurEff可能性的平均绝对变化为34%（P <.02）。ThorUS在41%的病例中改变了管理措施；胸腔穿刺术最为常见。