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在2019冠状病毒病大流行期间,产科医生如何对孕妇进行肺部超声检查及解读检查结果。

How to perform and interpret the lung ultrasound by the obstetricians in pregnant women during the SARS-CoV-2 pandemic.

作者信息

Yassa Murat, Mutlu Memiş Ali, Kalafat Erkan, Birol Pınar, Yirmibeş Cihangir, Tekin Arzu Bilge, Sandal Kemal, Ayanoğlu Esra, Yassa Mahmut, Kılınç Ceyhun, Tug Niyazi

机构信息

University of Health Sciences Turkey, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey.

Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey.

出版信息

Turk J Obstet Gynecol. 2020 Sep;17(3):225-232. doi: 10.4274/tjod.galenos.2020.93902. Epub 2020 Oct 2.

Abstract

OBJECTIVE

Evidence for the use of lung ultrasound scan (LUS) examinations in coronavirus 2019 pneumonia is rapidly growing. The safe and non-ionizing nature of LUS drew attention, particularly for pregnant women. This study aimed to contribute to the interpretation of LUS findings in pregnant women for the obstetricians.

MATERIALS AND METHODS

LUS was performed to pregnant women suspected of or diagnosed as having Severe Acute Respiratory syndrome coronavirus-2 (SARS-CoV-2) in the first 24 hours of admission. Fourteen areas (3 posterior, 2 lateral, and 2 anterior) were scanned per patient for at least 10 seconds along the indicated anatomical landmarks. The scan was performed in supine, right-sided and left-sided positions, respectively. Each area was given a score between 0 and 3 according to the specific pattern.

RESULTS

In this study, 21 still images and 21 videoclips that enabled dynamic and real-time evaluation were provided. Pleural line assessment, physiologic A-lines, pathologic B-lines, light beam pattern, white lung pattern, and specific patterns for quick recognition and evaluation are described.

CONCLUSION

The potential advantages and limitations of LUS and its areas of use for obstetricians are discussed. LUS is a promising supplementary imaging tool during the SARS-CoV-2 pandemic. It is easy to perform and may be feasible in the hands of obstetricians after a brief didactic course. It may be a firstline imaging modality for pregnant women.

摘要

目的

2019冠状病毒病肺炎中使用肺部超声扫描(LUS)检查的证据正在迅速增加。LUS的安全性和非电离特性引起了关注,尤其是对孕妇而言。本研究旨在为产科医生解读孕妇的LUS检查结果提供帮助。

材料与方法

对入院后最初24小时内疑似或确诊感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的孕妇进行LUS检查。每位患者沿着指定的解剖标志对14个区域(3个后侧、2个外侧和2个前侧)进行扫描,每次扫描至少10秒。扫描分别在仰卧位、右侧卧位和左侧卧位进行。根据特定模式,每个区域给予0至3分。

结果

本研究提供了21张静态图像和21段视频片段,可进行动态和实时评估。描述了胸膜线评估、生理性A线、病理性B线、光束模式、白肺模式以及用于快速识别和评估的特定模式。

结论

讨论了LUS的潜在优势和局限性及其在产科医生中的应用领域。在SARS-CoV-2大流行期间,LUS是一种有前景的辅助成像工具。它操作简便,经过简短的培训课程后,产科医生即可掌握。它可能是孕妇的一线成像方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ea3/7538823/4ec1cc0b4891/TJOG-17-225-g1.jpg

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