icu医师应用床旁超声快速诊断多发伤合并血胸的临床价值.docVIP

ICU医师应用床旁超声快速诊断多发伤合并血胸的临床价值 　　【摘要】 目的：探讨ICU医师应用床旁超声快速诊断多发伤合并血胸患者的可行性及临床价值，评价床旁超声在诊断及治疗决策中的优势。方法：对本院2015年7月-2016年8月ICU收治的73例多发伤合并血胸患者，全部患者均由经过专业培训的ICU医师进行胸部床旁超声检查。在床旁超声检查后2 h内，同时在病情允许下完成胸部CT及X线片检查，73例患者中有66例完成全部检查。以胸部CT检查的结果作为金标准，比较床旁超声和胸部X线片诊断创伤性血胸的临床价值。结果：66例多发伤合并血胸患者中，CT确诊血胸13例15侧，床旁超声诊断12例13侧，X线片诊断3例3侧。X线片与床旁超声的诊断比较差异有统计学意义（P 　　【关键词】 ICU医师； 床旁超声； 血胸； 快速诊断； 临床价值 　　The Clinical Value of ICU Medical Application of Bedside Ultrasound Diagnosis in Patients with Multiple Trauma Hemothorax/LIAO Yu，LU Mei-hua，WU Jian-fang，et al.//Medical Innovation of China，2016，13（33）：037-040 　　【Abstract】 Objective：To explore the application of bedside ultrasound physician ICU rapid diagnostic feasibility and clinical value of multiple trauma patients with hemothorax，advantage evaluation of bedside ultrasound in diagnosis and treatment.Method：In our hospital from July 2015 to August 2016 ICU treated 73 cases of multiple trauma with hemothorax，all patients were performed chest bedside ultrasonography by trained physicians ICU.CT and X-ray examination were performed at the same time in 2 h after bedside ultrasound examination，73 cases of 66 patients completed all the examination.The chest CT examination results as the gold standard， comparison of bedside ultrasound and chest X-ray diagnosis of traumatic hemothorax and the clinical value.Result：66 patients with multiple injuries combined with hemathorax，CT diagnosis of hemothorax in 13 cases 15 sides，bedside ultrasound diagnosis of 12 cases of the 13 side，X-ray diagnosis of 3 cases with 3 sides，there was significant difference in the diagnosis of X-ray and bedside ultrasound （P 　　First-author’s address：Longjiang Hospital in Shunde District of Foshan City，Foshan 528318，China 　　doi：10.3969/j.issn.1674-4985.2016.33.011 　　随着社会的发展和人口的增加，创伤已经成为人们的主要疾病之一，能否及时准确地做出诊断直接关系到患者的生命安全及预后。严重多发伤早期救治的重要环节是快速诊断，由于床旁超声具有方便、快捷、实时、动态、无放射性及可重复操作等特点，极其适用于急危重症患者的床旁检查。尤其是床旁超声的临床应用，是提高临床诊断和治疗水平最为重要的一项临床技术，近年来，国内外学者开始重视B超对肺部的检查价值[1-2]。严重的创伤性血胸对人体的危害非常大，在短时间内造