肺部超声诊断围手术期肺不张的Meta分析

Lung Ultrasound in the Diagnosis of Pulmonary Atelectasis:A Systematic Review and Meta-Analysis

目的系统评价肺部超声诊断围手术期患者肺不张的价值。方法检索数据库PubMed、EMbase、Cochrane图书馆、Web of Science、CNKI、CMB、VIP及COJ,检索时间为建库至2022年11月1日,采用QUADAS-2量表对纳入的文献进行质量评价。采用Meta Disc1.4、Stata15.0及Revman5.4进行数据分析,计算肺部超声诊断肺不张的合并敏感度(Sen)、特异度(Spe)、阳性似然比(PLR)、阴性似然比(NLR)与诊断比值比(DOR)。绘制合并受试者工作特征曲线(SROC)并计算其曲线下面积(AUC),进行异质性检验及Meta回归分析,绘制Deek's漏斗图分析是否存在发表偏倚。结果本文纳入9篇研究,结果显示肺部超声诊断围手术期肺不张的合并Sen、Spe、PLR、NLR及DOR分别为0.95(0.93,0.96)、0.84(0.77,0.89)、5.46(1.80,16.53)、0.09(0.03,0.28)及61.50(9.53,396.82),曲线下面积AUC值为0.9299。亚组分析及Meta回归未找到异质性来源,Deek's漏斗图显示无发表偏倚。结论肺部超声对围手术期肺不张具有较高的诊断价值,可作为围手术期患者肺部评估的重要检测工具。

Objective To systematically review the value of lung ultrasound in the detection of pulmonary atelectasis during the perioperative period.Methods The databases of PubMed,EMbase,Cochrane Library,Web of science,CNKI,CMB,VIP and COJ were searched during the period from their inception up to November 1st,2022.The quality of included literatures was assessed by QUADAS-2.The value of the lung ultrasound in the dignosis of atelectasis was analysed by Mteta Disc1.4,Stata15.0 and Revman5.4 software,the pooled sensitivity(Sen),spectificity(Spe),positive likelihood radio(PLR),negtive likelihood radio(NLR)and diagnostic odds radio(DOR)were calculated.The summary receiver operating characteristic curve(SROC)was drawn and its area under the curve(AUC)was calculated.The heterogeneity test and Meta-regression analysis were performed.The publication bias was conducted by Deek's test.Results Totally 9 articles were included in this study,the results of Meta-analysis showed that the pooled Sen,Spc,NLR and DOR were 0.95(0.93,0.96),0.84(0.77,0.89),5.46(1.80,16.53),0.09(0.03,0.28)and 61.50(9.53,396.82),respectively.The areas under the curves was 0.9299.Subgroup analysis and Meta-regression analysis did not find the source of heterogeneity.Deek's funnel plot showed no publication bias.Conclusion Lung ultrasound has high diagnostic performance for atelectasis and it can be used as an important tool to diagnose atelectasis in the perioperative patients.