ICU患者并发肺部感染的胸部超声和CT的诊断价值分析

Thoracic ultrasound and lung infection in ICU patients diagnostic value of CT controlled study

目的分析胸部超声和CT在重症监护室(intensive care unit,ICU)患者并发肺部感染的诊断价值。方法将2018年5月至2021年5月在浙江中医药大学附属温州中医院ICU住院治疗的103例疑似肺部感染患者纳入本研究中,均先后接受胸部CT、超声检查,保留完整图像,分析其征象表现,并以肺部感染金标准,比较分析两者的诊断效能。结果103例患者确诊肺部感染76例,无感染27例。超声征象主要是胸膜线异常,A、B线异常、肺实变及胸腔积液;CT征象主要是磨玻璃影、实变影及网格影或狭长细线样影等征象混合存在。CT诊断特异性为77.78%,敏感度为90.78%,准确度为87.38%,超声分别为74.04%、88.16%、84.47%,两种检查分别比较,差异无统计学意义(P>0.05)。结论胸部超声和CT在肺部感染诊断中均有良好效能,均有较高且一致的诊断准确性,对ICU患者可应用床旁胸部超声进行肺部感染诊断。

Objective To compare and analyze the diagnostic value of chest ultrasound and CT in patients with pulmonary infection in intensive care unit(ICU),so as to provide basis for the diagnosis and treatment of pulmonary infection.Methods A total of 103 patients with suspected pulmonary infection who were hospitalized in the ICU of Wenzhou Hospital of Traditional Chinese Medicine affiliated to Zhejiang University of Traditional Chinese Medicine from May 2018 to May 2021 were included in the observation study.They all received chest CT and ultrasound examinations successively,retained complete images,analyzed their signs and manifestations,and compared and analyzed their diagnostic efficacy based on the gold standard of pulmonary infection.Results A total of 76 cases were diagnosed as pulmonary infection in 103 patients,27 cases were not.The main ultrasonic signs were abnormal pleural line,abnormal A and B lines,pulmonary consolidation and pleural effusion;The CT signs were mainly a mixture of ground glass shadow,consolidation shadow,grid shadow or long thin line like shadow.The specificity of CT diagnosis was 77.78%,the sensitivity was 90.78%,the accuracy was 87.38%,and the ultrasound diagnosis was 74.04%,88.16%,84.47%,respectively,there was no significant difference between the two examinations(P>0.05).Conclusion Both chest ultrasound and CT have good efficacy in the diagnosis of pulmonary infection,and both have high and consistent diagnostic accuracy.Bedside chest ultrasound can be used for the diagnosis of pulmonary infection in ICU patients.