肺部超声在新型冠状病毒肺炎中的应用观察

Application observation of lung ultrasound in COVID-19

目的通过肺部超声了解新型冠状病毒肺炎(corona virus disease 2019,COVID-19)的影像学特点,探讨肺部超声B线评分(LUBS)在COVID-19病情评估方面的应用价值。方法选取2020年1月至3月在本院经呼吸道分泌物病毒核酸检测确诊的COVID-19患者11例,男6例,女5例,年龄(43.6±14.5)岁。在治疗前期和治疗后期参照床旁肺部超声(BLUE)方案对肺部进行超声探查,描述B线数目、肺实变或胸腔积液、胸膜线形态等影像学特点,并计算LUBS,与同步的氧合指数(PaO2/FiO2)进行关联性分析。同时,也对同一确诊患者治疗前后的B线评分变化进行配对分析。结果11例COVID-19确诊患者均可探及数量不等的B线,融合B线5例、肺实变5例、胸膜线中断或不光滑3例。LUBS与同步的PaO2/FiO2呈显著的负相关关系(r=-0.59,P=0.004),且治疗前后的LUBS差异有统计学意义(P<0.05)。结论在COVID-19诊治过程中,LUBS有助于实时、安全而便捷掌握肺部病变情况,为评估COVID-19病情提供一定的参考价值。

Objective To understand the imaging features of corona virus disease 2019(COVID-19)by lung ultrasound,and to explore the application value of lung ultrasound B-line score(LUBS)in the evaluation of COVID-19.Methods Eleven patients with COVID-19 confirmed by virus nucleic acid test of respiratory secretions in our hospital from January to March 2020 were selected,including 6 males and 5 females,with the age of(43.6±14.5)years old.The lung ultrasound exploration was performed according to the BLUE scheme in the early and later stage of treatment,and imaging features such as the number of B-line,pulmonary consolidation or pleural effusion,and pleural line morphology were described,the LUBS was calculated,and its correlation with synchronous oxygenation index(PaO2/FiO2)was analyzed.The change of the LUBS of the same confirmed case before and after treatment was also matched and analyzed simultaneously.Results A different number of B-lines could be detected in all the 11 patients diagnosed with COVID-19,and there were 5 cases of integration B-line,5 cases of pulmonary consolidation,and 3 cases of interrupted or not smooth pleural line.There was a significant negative correlation between the LUBS and the synchronous PaO2/FiO2(r=-0.59,P=0.004),and there was a statistically significant difference in the LUBS before and after the treatment(P<0.05).Conclusion In the diagnosis and treatment of COVID-19,the LUBS helps to grasp the condition of lung lesions in real time,safely and conveniently,and provides a certain reference value for evaluating the condition of COVID-19.