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使用口袋大小的超声术前检测胸腔粘连。

Preoperative detection of pleural adhesions using pocket-sized ultrasound.

机构信息

Department of Thoracic Surgery, Toho University Sakura Medical Center, Sakura, Japan.

出版信息

Asian Cardiovasc Thorac Ann. 2021 Jun;29(5):400-404. doi: 10.1177/0218492321997083. Epub 2021 Feb 18.

Abstract

BACKGROUND

Although preoperative detection of pleural adhesions is important in thoracic surgery, it is not widely performed. We report the availability of a pocket-sized ultrasound device for the preoperative detection of pleural adhesions.

METHODS

Between September 2019 and September 2020, pleural adhesions were assessed preoperatively using a pocket-sized ultrasound device in 62 patients who underwent thoracic surgery. Evaluations were performed using the Vscan Dual Probe on the wards or just before surgery in the operating theater. We used a linear probe to scan the chest wall where the incision was scheduled, and evaluated the sliding sign. We compared ultrasound results with intraoperative findings.

RESULTS

Of the 62 patients, the sliding sign was observed in 58 patients, 56 of whom demonstrated no pleural adhesions intraoperatively. The sensitivity was 96.6%. Four patients were negative for the sliding sign; of these, three had pleural adhesions and one did not. The specificity was 75.0%. Among all 62 patients, the diagnostic accuracy of ultrasound for pleural adhesions was 95.2%. False negatives were caused by loose adhesions. False positives were caused by the absence of vertical lines on ultrasound. Accuracy was not influenced by the timing of the test.

CONCLUSIONS

A pocket-sized ultrasound device was useful for the preoperative detection of pleural adhesions in thoracic surgery.

摘要

背景

尽管术前检测胸膜粘连对于胸外科手术很重要,但目前尚未广泛开展。我们报告了一种可用于术前检测胸膜粘连的袖珍式超声设备。

方法

2019 年 9 月至 2020 年 9 月,我们对 62 例拟行胸外科手术的患者使用袖珍式超声设备进行术前胸膜粘连评估。评估在病房或手术室中手术前使用 Vscan 双探头进行。我们使用线性探头扫描预定切口的胸壁,并评估滑动征。我们将超声结果与术中发现进行比较。

结果

在 62 例患者中,58 例患者观察到滑动征,其中 56 例术中无胸膜粘连。超声检测的灵敏度为 96.6%。4 例滑动征阴性患者中,3 例术中存在胸膜粘连,1 例无粘连。超声检测的特异性为 75.0%。在所有 62 例患者中,超声对胸膜粘连的诊断准确率为 95.2%。假阴性是由于粘连疏松所致,假阳性是由于超声上无垂直线所致。检测时机对准确性无影响。

结论

袖珍式超声设备可用于胸外科手术中术前检测胸膜粘连。

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