床旁肺部超声在急性呼吸困难患者诊断中的应用

Application of Bedside Pulmonary Ultrasound in Diagnosis of Patients with Acute Dyspnea

目的分析床旁肺部超声在急性呼吸困难患者诊断中的应用。方法选取2022年1月—2023年6月新疆生产建设兵团第五师医院诊治的急性呼吸困难患者50例,均进行床旁肺部超声检查、常规检查,以患者病史、临床表现、实验室检查、肺功能测试、胸部CT等综合诊断手段的结果为金标准,分析床旁肺部超声、常规检查对急性呼吸困难患者急性心源性肺水肿、肺实变、气胸、胸膜炎诊断的灵敏度、特异度、阳性预测值、阴性预测值。结果床旁肺部超声诊断急性呼吸困难患者急性心源性肺水肿、肺实变、气胸、胸膜炎的灵敏度、特异度、阳性预测值、阴性预测值与金标准比较,差异无统计学意义(P>0.05)。床旁肺部超声诊断急性呼吸困难患者急性心源性肺水肿、肺实变、气胸、胸膜炎的灵敏度分别为90.00%、85.71%、75.00%、94.44%高于常规检查,差异有统计学意义(χ^(2)=8.230、6.190、9.283、7.306,P<0.05);床旁肺部超声的特异度、阳性预测值、阴性预测值也显著优于常规检查,差异有统计学意义(P<0.05)。。结论床旁肺部超声在急性心源性肺水肿、肺实变、气胸、胸膜炎引起的急性呼吸困难中诊断价值显著,能够及时为治疗提供准确的指导。

Objective To analyze the application of bedside pulmonary ultrasound in the diagnosis of patients with acute dyspnea.Methods,50 patients with acute dyspnea were selected from Xinjiang Production and Construction Corps Fifth Division Hospital from January 2022 to June 2023 were examined by bedside lung ultrasound and routine examination.The gold standard was the results of patient history,clinical manifestations,laboratory examination,lung function test,chest CT and other comprehensive diagnostic means.The sensitivity,specificity,positive predictive value and negative predictive value of bedside pulmonary ultrasound and routine examination in the diagnosis of acute cardiogenic pulmonary edema,lung consolidation,pneumothorax and pleurisy in patients with acute dyspnea were analyzed.Results There was no statistically significant difference in sensitivity,specificity,positive predictive value and negative predictive value in the diagnosis of acute cardiogenic pulmonary edema,lung consolidation,pneumothorax and pleurisy in patients with acute dyspnea by bedside pulmonary ultrasound compared with gold standard(P>0.05).The sensitivity of bedside pulmonary ultrasound in the diagnosis of acute cardiogenic pulmonary edema,lung consolidation,pneumothorax and pleurisy in patients with acute dyspnea was 90.00%,85.71%,75.00%and 94.44%,respectively,higher than that of routine examination,and the difference was statistically significant(χ^(2)=8.230,6.190,9.283,7.306,P<0.05).The specificity,positive predictive value and negative predictive value of bedside lung ultrasound were also significantly better than those of routine examination,and the difference was statistically significant(P<0.05).Conclusion Bedside lung ultrasound has significant diagnostic value in acute dyspnea caused by acute cardiogenic pulmonary edema,lung consolidation,pneumothorax and pleurisy,and can provide accurate guidance for treatment in time.