[1]崔丽清,何琳,谢敏,等.肺超声在成人社区获得性肺炎诊断和随访中的应用价值[J].第三军医大学学报,2018,40(18):1699-1703.
 Cui Liqing,He Lin,Xie Min,et al.Value of lung ultrasound in diagnosis and follow-up of community-acquired pneumonia in adult patients[J].J Third Mil Med Univ,2018,40(18):1699-1703.
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肺超声在成人社区获得性肺炎诊断和随访中的应用价值(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
40卷
期数:
2018年第18期
页码:
1699-1703
栏目:
临床医学
出版日期:
2018-09-30

文章信息/Info

Title:
Value of lung ultrasound in diagnosis and follow-up of community-acquired pneumonia in adult patients
作者:
崔丽清何琳谢敏谢涛
重庆医科大学附属大学城医院超声科
Author(s):
Cui Liqing He Lin Xie Min Xie Tao

Department of Ultrasonography, Affiliated Hospital of Chongqing Medical University, Chongqing, 401331, China

关键词:
社区获得性肺炎肺超声肺实变
Keywords:
community acquired pneumonia lung ultrasound lung consolidation
分类号:
R445.1;R563.1
文献标志码:
A
摘要:

目的     明确肺超声在成人社区获得性肺炎诊断中的准确性及随访的可行性。方法    对2017年2-12月我院呼吸科39例疑诊社区获得性肺炎患者同时行肺超声和胸部CT检查(“金标准”对照),分析肺超声对社区获得性肺炎的诊断价值。肺超声的随访在治疗第5~7天、第10~14天进行,评估肺实变位置、实变范围、空气支气管征和胸腔积液的比例。结果     39例患者中经胸部CT诊断社区获得性肺炎31例,经肺超声诊断社区获得性肺炎28例。肺超声诊断肺炎的敏感性为90.3%,特异性为87.5%,肺超声诊断肺炎的阳性预测值为96.6%,阴性预测值为70%;超声诊断显示82.1%患者空气支气管征阳性,35.7%患者胸腔积液。在治疗第10~14天,病灶面积中位数由8.75 cm2降至2.65 cm2,病灶面积变化差异有统计学意义(P<005);空气支气管征比例从82.1%降至62.5%,胸腔积液比例从35.7%至完全消失。结论     肺超声诊断社区获得性肺炎准确率高,能动态实时观察病灶变化,是一种无创的、重复性好的、可靠的检查手段,可用于成人社区获得性肺炎的诊断和随访。

Abstract:

Objective    To investigate the diagnostic accuracy of lung ultrasound (LUS) for community acquired pneumonia (CAP) in adult patients and the value of LUS in the follow-up of the patients. Methods     Thirty-nine adult patients with a suspected diagnosis of CAP in our respiratory center underwent examinations with both LUS and chest computed tomography (CT). With the CT findings as the gold standard for diagnosing CAP, we analyzed the diagnostic value of LUS in CAP. Follow-up LUS examinations were performed for these patients during days 5 to 7 and days 10 to 14 of the treatment to evaluate the position and range of lung consolidation, the presence of air bronchogram, and the changes in pleural effusion. Results    Of the 39 patients with a suspected diagnosis, 31 had an established diagnosis of CAP by chest CT, and 28 had a definite diagnosis by LUS. The diagnostic sensitivity of LUS for pneumonia in these patients was 90.3%, with a diagnostic specificity of 87.5%, a positive predictive value of 96.6%, and a negative predictive value of 70%. Of the 31 patients with a definite diagnosis of CAP, 82.1% presented with air bronchogram and 35.7% had pleural effusion based on the findings by LUS. In 10 to 14 days during the treatment, the median area of the lesion was reduced significantly from 8.75 cm  to 2.65 cm  (P<0.05), the percentage of patients with air bronchogram decreased from 82.1% to 62.5%, and pleural effusion completely disappeared in all the patients. Conclusion    LUS has a high diagnostic accuracy for CAP and allows dynamic observation of the changes of the pulmonary lesions. As a noninvasive modality with a good repeatability and reliability, LUS can be used for the diagnosis and follow-up of CAP in adult patients.

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更新日期/Last Update: 2018-09-29