床旁超声对社区获得性肺炎老年患者的诊断价值

Diagnostic value and serious evaluation of bedside accidents for community-acquired slip

目的探讨床旁超声检查对于诊断社区获得性肺炎老年患者的诊断价值。方法选取本院2019年8月~2020年6月收治的120例社区获得性肺炎老年患者作为感染组、60例健康志愿者作为对照组,两组分别接受床旁超声的检查,对比两组的肺部超声征象(A线征象、B线征象、肺实变征象)及肺部超声评分,并根据患者病情程度进行分层对比,采用ROC曲线分析肺部超声评分诊断肺部感染的价值。结果感染组的A线征象、B线征象、肺实变征象检出率及肺部超声评分均高于对照组,差异具有统计学意义(P<0.05).CPIS评分>6分的感染组患者的肺实变征象检出率及肺部超声评分均高于CPIS评分≤6分的患者,差异具有统计学意义(P<0.05);CPIS评分>6分的感染组患者的A线征象、B线征象与CPIS评分≤6分的患者比较,差异无统计学意义(P>0.05);死亡组患者的B线征象、肺实变征象检出率及肺部超声评分均高于存活患者,差异具有统计学意义(P<0.05);肺部超声评分诊断肺部感染的敏感度为89.87%,特异性为83.36%,漏诊率为10.13%,误诊率为16.64%,ROC曲线下面积值为0.913。结论床旁超声检查对于诊断社区获得性肺炎老年患者及病情判断均具有较高的临床价值。

Objective To explore the clinical value of bedside ultrasound in diagnosing elderly patients with community-acquired pneumonia.Methods A total of 120 elderly patients with community-acquired pneumonia admitted to Chongqing Dazu District People's Hospital from August 2019 to June 2020 were selected as the infection group and 60 healthy volunteers as the control group.The patients received bedside ultrasound examinations.The lung ultrasound signs(A-line signs,B-line signs,lung consolidation signs)and lung ultrasound scores,and stratified comparison according to the patient's condition between two groups were compared.ROC curve was used to analyze the value of pulmonary ultrasound score in the diagnosis of pulmonary infection.Results The detection rate of A-line signs,B-line signs,lung consolidation signs and lung ultrasound scores of the infection group were significantly higher than those of the control group(P<0.05).The detection rate of lung consolidation signs and lung ultrasound scores of patients in the infection group with a CPIS score>6 points were significantly higher than those of patients with a CPIS score≤6 points(P<0.05).The A-line signs and B-line signs of patients in the infection group with a CPIS score>6 were compared with those with a CPIS score of≤6,(P>0.05).The detection rate of B-line signs,lung consolidation signs,and lung ultrasound scores of patients in the death group were significantly higher than those of the surviving patients(P<0.05).The sensitivity of lung ultrasound scoring to diagnose lung infection was 89.87%,specificity was 83.36%,missed diagnosis rate was 10.13%,misdiagnosis rate was 16.64%,and the AUC value of the area under the ROC curve was 0.913.Conclusion Bedside ultrasound examination has high clinical value for diagnosing elderly patients with community-acquired pneumonia and judging their condition.