机械通气多发伤患者肺不张/实变的超声诊断及影像学特点分析

Ultrasonic Diagnosis and Imaging Characteristics Analysis of Atelectasis/Consolidation in Patients with Multiple Injuries of Mechanical Ventilation

目的探讨超声诊断在机械通气多发伤患者肺不张/实变中的超声及CT对比的影像学特点。方法方便选取该院2018年8月-2019年12月ICU接受机械通气治疗的多发伤患者88例,对患者行CT与超声检查,以胸部CT为标准,分析超声诊断结果的差异性及超声影像学特点。结果 88例患者352个肺区中,胸部CT发现162个肺区存在肺不张/实变(46.02%),超声检查中有138个(39.20%),数据对比差异无统计学意义(χ^(2)=3.346,P>0.05);其中,胸部CT检出162个肺区中大块型92个,部分型70个,超声检出138个肺区中大块型95个,部分型43个,大块型二者差异无统计学意义(P>0.05),部分型二者数据差异有统计学意义(P<0.05)。超声图像分析显示,不同类型肺不张/实变的完全性及不全性差异有统计学意义(P<0.05)。结论机械通气多发伤患者的超声与胸部CT诊断一致性较高,超声观察病变范围和动态变化对指导肺复张有重要价值。

Objective To investigate the imaging characteristics of ultrasound and CT contrast in the diagnosis of atelectasis/consolidation in patients with multiple injuries of mechanical ventilation.Methods Eighty-eight patients with multiple injuries who received mechanical ventilation in the ICU from August 2018 to December 2019 in the hospital were conveniently selected.CT and ultrasound examinations were performed on the patients.The chest CT was used as the standard to analyze the differences in ultrasound diagnosis results and ultrasound imaging features.Results Among the 352 lung regions of 88 patients,CT showed atelectasis/consolidation in 162 lung regions(46.02%),and 138(39.20%)in ultrasound examination.There was no statistically significant difference in data comparison(χ^(2)=3.346,P>0.05);Among them,chest CT detected 92 of the 162 lung regions with bulk type,70 of the partial type,and ultrasound detected 95 of the138 lung regions with bulk type,43 of the partial type,bulky had no statistically significant difference between the two types(P>0.05),and the data difference between the two types was statistically significant(P<0.05).Ultrasound image analysis showed that the completeness and incompleteness of different types of atelectasis/consolidation were also statistically significant.Conclusion The diagnostic consistency between ultrasound and chest CT in patients with multiple injuries of mechanical ventilation is relatively high.Ultrasound observation of lesion range and dynamic changes is of great value in guiding lung recruitment.