超声诊断重症肺炎的临床价值

Clinical value of lung ultrasound combined with laboratory indexes in evaluation of severe pneumonia

目的探讨超声诊断重症肺炎的临床价值。方法选取2017年2月至2021年10月宿州市第一人民医院收治的98例重症肺炎患者(重症肺炎组),并选择同一时间段医院接收的98例普通肺炎患者(普通肺炎组)及98例健康志愿者(健康组)。对比3组肺部超声评分及诊断肺炎的相关实验室指标降钙素原(PCT)、C反应蛋白(CRP)水平,分析超声评分对重症肺炎的诊断价值。结果重症肺炎组患者肺部超声评分、PCT及CRP水平高于普通肺炎组,普通肺炎组患者肺部超声评分、PCT及CRP水平高于健康组(P均<0.05)。重症肺炎并发急性呼吸窘迫综合症(ARDS)发生率为24.49%,肺部超声评分达到(19.88±1.83)分,是诊断重症肺炎并发症ARDS的重要依据,且并发ARDS者各项监测指标均高于未未并发ARDS者(P<0.05)。对重症肺炎的诊断,肺部超声检测评分阳性率(91.84%)高于PCT(61.35%)、CRP(71.43%)实验室指标的检测(P<0.05)。结论超声对重症肺炎的诊断具有重要价值,优于肺炎的相关实验室指标PCT、CRP水平,同时为诊断重症肺炎并发症ARDS提供新的途径,为指导治疗节省时间,值得临床推广。

Objective To explore the clinical value of ultrasound in the diagnosis of severe pneumonia.Methods 98 patients with severe pneumonia treated in Suzhou First People's Hospital from February 2017 to October 2021 were recorded as severe pneumonia group,and 98 patients with ordinary pneumonia and 98 healthy volunteers received in our hospital at the same time were recorded as ordinary pneumonia group and healthy group.The lung ultrasound score,PCT and CRP levels of the three groups were comparable,and the diagnostic value of ultrasound score in severe pneumonia was analyzed.Results The lung ultrasound scores,PCT and CRP levels of the patients with severe pneumonia group were higher than those of the ordinary pneumonia group,and the lung ultrasound scores,PCT and CRP levels of the patients with ordinary pneumonia group were higher than those of the healthy group(all P<0.05).The incidence of severe pneumonia complicated with acute respiratory distress syndrome(ARDS)was 24.49%.Pulmonary ultrasound score,PCT and CRP level were of great significance in the diagnosis of complicated ARDS.Pulmonary ultrasound score reached(19.88±1.83)score,which was an important basis for the diagnosis of severe pneumonia complicated ARDS,and the monitoring indexes of complications were higher than those in the non complicated group(P<0.05).For the diagnosis of severe pneumonia,the positive rate of pulmonary ultrasound score(91.84%)was higher than that of PCT(61.35%)and CRP(71.43%)(P<0.05).Conclusion Ultrasound has an important value in the diagnosis of severe pneumonia,which is better than the level of PCT and CRP.At the same time,it provides a new way for the diagnosis of severe pneumonia complication ARDS,saves time for guiding clinical treatment,and is worth popularizing.