检验医学与临床2018，Vol.15Issue(10)：1411-1413,1417,4.DOI:10.3969/j.issn.1672-9455.2018.10.012
肺部超声在危重患者监测血管外肺水的初步研究
Application of pulmonary ultrasonography in monitoring extravascular lung water in critically ill patients
张晓霞 1顾俊文2
作者信息
- 1. 新疆医科大学第一附属医院急诊科,乌鲁木齐830054
- 2. 新疆医科大学第一附属医院昌吉分院 831100
- 折叠
摘要
Abstract
Objective To evaluate the simplified pulmonary ultrasound assessment as a tool for assessing EVLW in critically ill patients entering the multicellular intensive care unit(ICU).Methods A total of 49 critically ill patients who needed mechanical ventilation were enrolled in the EICU hospital from January 2017 to June 2017.Lung ultrasound and thermal dilution(PiCCO system)were performed by two independent op-erators.The number of B lines was recorded by lung ultrasonography,and then the difference between the number of B lines between different diseases,and the parameters obtained from the B line and PiCCO system were compared.The correlation between the positive quadrant of the B line and the EVLWI was also evalua-ted.Learning software for analysis.Results A total of 49 patients completed lung ultrasonography and PiCOO assessment after admission.The average age was(65.9 ± 5.3)years old.Among them,16 cases had B line number <10.27 cases was always >10,and 14(28.6%)had the increase or decrease.The number of B lines in patients with AMI was significantly lower than in respiratory disease(P<0.001).There was no significant difference in the number of B lines between heart failure and COPD(P=0.496)and acute respiratory failure (P=0.710).The number of B lines of ARDS was significantly higher than that of other diseases(P<0.001). There was a positive correlation between the number of B lines and the extravascular lung water index(EV-LEI)(r= 0.928,P< 0.001),and the number of B lines was negatively correlated with PaO2/FiO2(r=―0.876,P<0.001).When EVLWI was calculated using the actual weight,EVCOW was used to monitor the specificity(60%)and sensitivity(100%)of B line positive in more than 3 quadrants when EVLWI>10 mL/kg(area under the ROC curve:0.918;95% CI:0.846―0.991,P=0.037),using predicted body weight,more than 4 quadruples have B positive specificity(100%)and sensitivity(65%)(area under the curve:0.862;95%CI:0.759―0.965,P=0.004 8).Conclusion Simplified pulmonary ultrasound can be used as a reliable non-invasive bedside monitoring tool for predicting extravascular lung water in emergency and critically ill pa-tients.关键词
肺部超声/血管外肺水/B线数目Key words
pulmonary ultrasound/extravascular lung water/number of B lines分类
医药卫生引用本文复制引用
张晓霞,顾俊文..肺部超声在危重患者监测血管外肺水的初步研究[J].检验医学与临床,2018,15(10):1411-1413,1417,4.
