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急诊急性呼吸衰竭患者的床旁超声诊断价值。

Diagnostic role of thoracic ultrasound in patients with acute respiratory failure at emergency service.

机构信息

Department of Emergency Medicine, Adana City Research and Training Hospital, Health Science University, 01060, Adana, Turkey.

Department of Emergency Medicine, Faculty of Medicine, Çukurova University, Adana, Turkey.

出版信息

Ir J Med Sci. 2024 Jun;193(3):1573-1579. doi: 10.1007/s11845-024-03618-4. Epub 2024 Feb 3.

Abstract

BACKGROUND AND AIM

This study aimed to elucidate the effectiveness of bedside thoracic ultrasound according to BLUE protocol and to investigate its superiority over other imaging methods in the emergency service.

METHODS

A total of 120 patients admitted to our institution's emergency care department due to respiratory distress have been enrolled in this prospective research. Thorax USG has been performed in the right and left hemithorax at the points specified in the BLUE protocol for each patient. Pleural sliding motion, A-lines, B-lines, consolidation, effusion, and the presence of barcode signs were evaluated individually. Age, sex, comorbid diseases, other radiological examination findings, laboratory findings, final clinical diagnosis, and hospitalization-discharge status of the patients were recorded.

RESULTS

When a correct diagnosis of pneumonia has been analyzed for imaging techniques, the diagnostic rate of chest radiography was 83.3%, CT was 100.0%, and USG was 66.6%. The correct diagnostic rate of chest radiography was 94.5%; CT and USG were 100.0%. The correct diagnosis of pulmonary edema on chest radiography was 94.5%; CT and USG were 100.0%. While the correct diagnosis of pleural effusion on chest radiography and CT was 100.0%, it was 92.3% in USG imaging. Finally, CT and USG imaging performed better than chest radiography in patients with pneumothorax (chest radiography 80.0%, CT and USG 100%).

CONCLUSION

USG imaging could be preferred in the diagnosis of pneumonia, pulmonary edema, pleural effusion, pneumothorax, pulmonary embolism, and differential diagnosis at the emergency service.

摘要

背景与目的

本研究旨在阐明床边胸部超声检查(BLUE 方案)的有效性,并探讨其在急诊服务中优于其他影像学方法的优势。

方法

本前瞻性研究共纳入 120 例因呼吸窘迫而入住我院急诊部的患者。对每位患者均按 BLUE 方案在左右半胸的指定部位进行胸部超声检查。分别评估胸膜滑动运动、A 线、B 线、实变、积液和条码征的存在。记录患者的年龄、性别、合并症、其他影像学检查结果、实验室检查结果、最终临床诊断和住院/出院情况。

结果

在分析影像学技术对肺炎的正确诊断时,胸部 X 线摄影的诊断率为 83.3%,CT 为 100.0%,超声为 66.6%。胸部 X 线摄影的正确诊断率为 94.5%;CT 和超声为 100.0%。胸部 X 线摄影对肺水肿的正确诊断率为 94.5%;CT 和超声为 100.0%。而胸部 X 线摄影和 CT 对胸腔积液的正确诊断率为 100.0%,超声为 92.3%。最后,在气胸患者中,CT 和超声检查的诊断效果优于胸部 X 线摄影(胸部 X 线摄影 80.0%,CT 和超声 100%)。

结论

在急诊服务中,超声成像可优先用于肺炎、肺水肿、胸腔积液、气胸、肺栓塞和鉴别诊断。

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