肺部超声在老年新型冠状病毒肺部感染的应用价值

Application value of lung ultrasound in elderly patients with COVID-19

目的探讨肺部超声(LUS)在高龄(≥75岁)感染新型冠状病毒肺炎(COVID-19)患者中的应用及后续对病程的监测及诊断价值。方法回顾性分析2022年11月1日—2023年1月15日本院内科收治的25例COVID-19高龄患者进行病例归纳总结,除临床资料外,动态监测肺部超声检查情况,并与肺CT结果对比,观察检查结果,以及对病程转归的预判及影响。结果LUS检查提示患者出现不同程度肺间质损伤,包括离散型B线(间质渗出)或融合型B线(渗入肺泡)以及肺实变(肺泡萎陷)。随着病情好转,LUS可见肺实变范围缩小,B线逐步稀疏到消散,A线出现。结论LUS与同期胸部CT结果一致性良好。LUS检查安全简便,重复性好,可实时动态监测,即可作为初筛手段,亦可运用于特殊人群,协助临床治疗决策。

Objective To explore the application and follow-up monitoring and diagnostic value of lung ultrasound(LUS)in elderly patients(≥75y)with novel coronavirus pneumonia(COVID-19).Methods Data of 25 COVID-19 elderly patients admitted to the Department of Internal Medicine from November 1,2022 to January 15,2023 were retrospectively analyzed and summarized.In addition to clinical data,dynamic monitoring of LUS was performed,and the results were compared with lung CT results.The examination results,as well as the prediction and impact on the course of disease were observed.Results LUS imaging indicated that patients had different degrees of interstitial lung injury,including discrete type B line(interstitial exudation)or fusion type B line(alveolar infiltration)and lung consolidation(alveolar collapse).With the improvement of the disease,the range of lung consolidation seen in LUS was reduced,the B-line was gradually sparse to dissipate,and the A-line appeared.Conclusions The results of LUS and chest CT in the same period are consistent.LUS examination is safe,simple,reproducible,and can be monitored dynamically in real time.It can be used as a primary screening method,and also be used in special patients to assist clinical treatment decision-making.