床边B超在ARDS肺复张监测中的应用分析

目的 探讨床边肺超声方法对ARDS肺复张及保持肺开放效果。方法 通过对2012年11月—2014年3月在该院进行住院治疗的30例急性呼吸窘迫综合征肺复张患者给予床边B超,评价患者的肺损伤程度及肺复张容积,比较患者的肺损伤程度和氧合指数的一致性,肺含气超声评分同P-V曲线相关性分析。结果 所有患者经超声检查阳性率为100%,超声评分为（24.6±7.1）分,经Kappa检验K=0.475,具有良好的一致性;肺复张平均容积为（494.9±212.5）mL,通过对肺含气超声评分同P-V曲线相关性分析,r=0.82,P〈0.05,差异有统计学意义,表明肺含气超声评分同P-V曲线具有良好的相关性。结论 床边B超可以有效测定患者的肺部损伤程度,肺含气超声评分同P-V曲线相关性分析具有良好相关性,临床值得推广应用。

Analysis of the Application of Bedside B Ultrasound in Monitoring ARDS Lung Recruitment

Objective To investigate the effect of bedside lung ultrasound methods on ARDS lung recruitment and keeping open lung. Methods 30 cases with acute respiratory distress syndrome lung recruitment admitted in our hospital from November 2012 to March 2014 were treated with bedside B ultrasound. The degree of lung injury＇and recruited lung volume of the patients were evaluated. And the consistency between the degree of lung injury and oxygenation index was compared, the correlation between ultrasound score of gas contained in the lung and P-V curve was analyzed. Results The positive rate of all the patients was 100%, ultrasound score was （24.6 ±7.1） points, testing by Kappa K=0.475, has good consistency; the average recruited lung volume was （494.9±212.5） ml, the analysis of the correlation between ultrasound score of gas contained in the lung and P-V curve showed that ultrasound score of gas contained in the lung had good correlation with P-V curve with statistically significant difference, r=0.82, P〈0.05. Conclusion The bed B ultrasound can effectively determine the degree of lung injury; ultrasound score of gas contained in the lung has good correlation with P-V curve, which is worthy of clinical application.