超声和X线对急性气胸患者的诊断价值

The diagnostic value of ultrasound and X-ray in patients with acute pneumothorax

目的分析超声和X线对急性气胸患者的诊断价值,为临床早期治疗急性气胸患者提供参考。方法选取急诊病房2016年1月至2018年1月收治的96例多发伤患者,入院后均采取胸部超声、X线和CT检查。以CT结果为金标准,分析X线和超声诊断急性气胸的结果,比较两组结果的灵敏度、特异度、阳性预测值、阴性预测值、部位和时效等。结果 20例(23侧)患者经CT诊断为气胸;超声诊断气胸共22侧,漏诊1侧; X线诊断气胸12侧,漏诊11侧。超声诊断气胸的灵敏度及阴性预测值明显高于X线检查,差异有统计学意义(P <0. 05)。CT诊断前胸部急性气胸11侧中,超声1侧漏诊,而X线全部漏诊。超声诊断平均耗时(6. 5±1. 4) min,明显短于X线的(23. 1±4. 9) min和CT的(32. 5±6. 6) min,差异有统计学意义(P <0. 05)。结论超声对急性气胸的诊断价值和CT相近,且优于X线。

Objective To analyze the diagnostic value of ultrasound and X- ray in patients with acute pneumothorax, and to provide reference for clinical early treatment of acute pneumothorax. Methods 96 patients with multiple injuries in the emergency ward from January 2016 to January 2018 were selected, and they were given chest ultrasound, X - ray and CT examination after admission. The CT results were taken as the gold standard. The results of X - ray and ultrasound in the diagnosis of acute pneumothorax were analyzed. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, position, timeliness were compared belween the two groups. Results 20 cases （23 sides） of patients were diagnosed as pneumothorax by CT; 22 sides of pneumothorax were diagnosed by ultrasound, and 1 side was missed; 12 sides of pneumothorax were diagnosed by X - ray, and 11 sides were missed. The sensitivity and negative predictive value of ultrasound in the diagnosis of pneumothorax were higher than those of X - ray （P 〈0. 05） . In 11 sides of pneumothorax located in anterior chest diagnosed by CT, 1 side was missed by ultrasound and all were missed by X - ray. The average diagnostic time - consuming of ultrasound [ （6.5 ± 1.4） min] was shorter than that of X - ray and CT [ （23.1± 4.9）, （32. 5 ± 6.6） min] （P 〈 0. 05） . Conclusion The diagnostic value of ultrasound for acute pneumothorax is similar to that of CT and superior to X - ray.