床旁超声和胸部X线检查在重症肺炎诊断中的临床对比观察.docx

·1366· 生堡急趁医堂苤查呈Q!兰生!兰旦筮垫鲞筮12翅g丛!』垦塑!监丛堕：卫塑!堡垒塑兰Q!堡：y!!：蛰：塑!：!呈 ·1366· 生堡急趁医堂苤查呈Q!兰生!兰旦筮垫鲞筮12翅g丛!』垦塑!监丛堕：卫塑!堡垒塑兰Q!堡：y!!：蛰：塑!：!呈 ·临床研究· 床旁超声和胸部x线检查在重症肺炎 诊断中的临床对比观察 张山红 张洪波 刘笑雷 张国强 【摘要】目的分析重症肺炎患者的肺部超声特征，探讨床旁超声诊断肺炎的临床价值。方 法以急诊留院治疗的疑诊重症肺炎患者为研究对象，对患者进行胸部x线检查(chest x—ray CXR)、肺部超声检查及胸部CT检查；分析床旁超声诊断重症肺炎的敏感性、特异性、阳性预测 值、阴性预测值及准确性，并与CXR进行比较。结果重症肺炎组出现肺实变的患者例数、有胸 膜改变的肋间个数、胸膜下病变个数以及合并有胸腔积液的患者例数均高于非重症肺炎组。床旁超 声诊断重症肺炎的敏感性为95．7％，特异性为97．1％，阳性预测值为98．5％，阴性预测值为 89．5％，准确性为96．2％。与CXR比较，两者在敏感性、阴性预测值和准确性上差异具有统计学 意义。结论床旁超声是诊断重症肺炎可靠的辅助检查方法，诊断的敏感性、阴性预测值和准确性 优于CXR，广泛地开展胸部床旁超声检查可以提高重症肺炎的快速诊断，确立及时正确的治疗。 【关键词l超声检查；胸部x线检查；重症肺炎 Comparison of diagnostic performances between bedside sonography and chest x·ray in pneumoniaZHANG Shanhong，ZHANG Hongbo，LIU Xiaolei，ZHANG Guoqiang．Emergency Department， China—Japan Friendship Hospital，Beifing 100029，China Corresponding author：Zhang Hongbo，Email：jhzhb@126．com 【Abstract】OMeetive To evaluate the diagnostic performances of bedside lung ultrasound(US)and chest radiography(CXR)in patients with pneumonia．Method Lung ultrasound(US)，CXR and chest CT were performed in sequence in adult patients admitted the emergency department for suspected acute respiratory failure caused by pneumonia．Here，chest CT served a”golded standard”for comparison．The diagnostic efficacy of US for the detection of pneumonia，defined rapidity and accuracy(sensitivity，specificity，positive predictive value，negative predictive value)were compared with CXR．Results The number of patients with consolidation of lung，pleural alteration，subpleural pathological changes，and pleural effusion in the pneumonia group was higher than that in the pneumonia group．Sensitivity of bedside ultrasound examination for the diagnosis of pneumonia was 95．7％，and specificity 96．3％，positive predictive value 95．7％，negative predictive value 96．3％。and accuracy 96．0％．There were differences in sensitivity．negative predictive value and found between CXR and US．Conclusions Bedside chest ultr