重症监护病房床旁B超与胸部X线片检查对创伤性气胸的诊断价值研究

Value of ICU Bedside B-ultrasound and Chest X-ray in the Diagnosis of Traumatic Pneumothorax

目的比较重症监护病房(ICU)床边B超与胸部X线片检查对创伤性气胸的诊断价值。方法选取我院ICU收治的84例钝性胸部创伤患者,均行CT检查,随机分为B超组和X线组,各42例。B超组行床边B超检查,X线组行床边胸部X线片检查,将两组检查结果与CT结果对比。结果 B超组CT检查结果示气胸34例37侧,其中3例为双侧气胸,B超检查结果示气胸26例28侧,其中2例为双侧气胸;X线组CT检查结果示气胸33例35侧,其中2例为双侧气胸,胸部X线片检查结果示气胸25例26侧,其中1例为双侧气胸。B超组和X线组敏感度、特异度、阳性预测值、阴性预测值、准确度比较,差异均无统计学意义(P>0.05)。结论 ICU床边B超与胸部X线片诊断气胸敏感性、特异性无显著差异,B超检查方便、无创、可动态观察,方便实用。

Objective To investigate the value of bedside uhrasonography and chest X - ray in the diagnosis of pneu- mothorax. Methods 84 patients with blunt chest trauma admitted to the ICU of our hospital were given CT examination and were randomly divided into B - ultrasonography group and X - ray group with each group 42 cases. B - uhrasonography group was given bedside B - ultrasonography examination while X - ray group was given bedside chest X - ray examination. The results of the two groups were compared with the CT results. Results In B - uhrasonography group, CT examination results showed 37 sides of pneumothorax in 34 cases and 3 cases were bilateral pneumothorax. While B - uhrasonography examination results showed 28 sides of pneumothorax in 26 cases and 2 cases were bilateral pneumothorax. In X - ray group, CT examination results showed 35 sides of pneumothorax in 33 cases and 2 cases were bilateral pneumothorax. While X - ray examination results showed 26 sides of pneu- mothorax in 25 cases and one case were bilateral pneumothorax. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy between B - uhrasonography group and X - ray group showed no statistically significant difference （ P 〉 0. 05 ） . Conclusion B - ultrasonography and X - ray showed no statistically significant difference in sensitivity and speci- ficity in the diagnosis of pneumothorax. B - ultrasound is convenient, noninvasive and can be dynamically observed as a conven- ient and practical method.