在资源有限的环境中，将肺部超声与胸部X光片用于疑似肺炎诊断的比较。
Diagnostic use of lung ultrasound compared to chest radiograph for suspected pneumonia in a resource-limited setting.
作者信息
Amatya Yogendra, Rupp Jordan, Russell Frances M, Saunders Jason, Bales Brian, House Darlene R
机构信息
Department of General Practice and Emergency Medicine, Patan Academy of Health Sciences, PO Box 26500, Kathmandu, Nepal.
Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
出版信息
Int J Emerg Med. 2018 Mar 12;11(1):8. doi: 10.1186/s12245-018-0170-2.
BACKGROUND
Lung ultrasound is an effective tool for diagnosing pneumonia in developed countries. Diagnostic accuracy in resource-limited countries where pneumonia is the leading cause of death is unknown. The objective of this study was to evaluate the sensitivity of bedside lung ultrasound compared to chest X-ray for pneumonia in adults presenting for emergency care in a low-income country.
METHODS
Patients presenting to the emergency department with suspected pneumonia were evaluated with bedside lung ultrasound, single posterioranterior chest radiograph, and computed tomography (CT). Using CT as the gold standard, the sensitivity of lung ultrasound was compared to chest X-ray for the diagnosis of pneumonia using McNemar's test for paired samples. Diagnostic characteristics for each test were calculated.
RESULTS
Of 62 patients included in the study, 44 (71%) were diagnosed with pneumonia by CT. Lung ultrasound demonstrated a sensitivity of 91% compared to chest X-ray which had a sensitivity of 73% (p = 0.01). Specificity of lung ultrasound and chest X-ray were 61 and 50% respectively.
CONCLUSIONS
Bedside lung ultrasound demonstrated better sensitivity than chest X-ray for the diagnosis of pneumonia in Nepal.
TRIAL REGISTRATION
ClinicalTrials.gov, registration number NCT02949141 . Registered 31 October 2016.
背景
在发达国家，肺部超声是诊断肺炎的有效工具。在肺炎是主要死因的资源有限国家，其诊断准确性尚不清楚。本研究的目的是评估在低收入国家因急诊就诊的成年人中，床旁肺部超声与胸部X线对肺炎诊断的敏感性。
方法
对因疑似肺炎就诊于急诊科的患者进行床旁肺部超声、单次后前位胸部X线片和计算机断层扫描（CT）检查。以CT作为金标准，使用配对样本的McNemar检验比较肺部超声与胸部X线对肺炎诊断的敏感性。计算每项检查的诊断特征。
结果
在纳入研究的62例患者中，44例（71%）经CT诊断为肺炎。与胸部X线相比，肺部超声的敏感性为91%，胸部X线的敏感性为73%（p = 0.01）。肺部超声和胸部X线的特异性分别为61%和50%。
结论
在尼泊尔，床旁肺部超声对肺炎诊断显示出比胸部X线更好的敏感性。
试验注册
ClinicalTrials.gov，注册号NCT02949141。2016年10月31日注册。
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