肺部超声评分与简化临床肺部感染评分对VAP早期诊断与预后评估的价值

目的 分析肺部超声评分与简化临床肺部感染评分对呼吸机相关性肺炎(ventilator-associated pneumonia,VAP)早期诊断与预后评估的价值.方法 选取医院ICU收治的VAP患者100例,所有患者均行肺部超声评分以及简化临床肺部感染评分检查,观察肺部超声评分以及简化临床肺部感染评分在VAP中的诊断准...

The value of lung ultrasound score and simplified clinical pulmonary infection score in early diagnosis and prognostic evaluation of VAP

ObjectiveTo analyze the value of lung ultrasound score(LUS) and simplified clinical pulmonary infection score(sCPIS) in early diagnosis and prognosis evaluation of VAP.MethodsA total of 100 hospitalized patients in ICU with ventilator-associated pneumonia(VAP) were selected. All patients underwent evaluation by LUS and sCPIS to observe the diagnostic accuracy of LUS and sCPIS in VAP. The LUS and sCPIS at different time of treatment as well as the changes in WBC, PCT and hs-CRP were observed, and the predictive value of LUS and sCPIS in the prognosis of VAP patients was analyzed.ResultsLUS, sCPIS, and chest CT were of high accuracy in the diagnosis of VAP, however, there was no significant difference among them(P＞0.05). LUS and sCPIS as well as WBC, PCT and hs-CRP at 7 d after treatment were significantly lower than those at 3 d after treatment and the difference was statistically significant(P＜0.05). Within 28 d of diagnosis, 26 of 100 patients died, and 74 cases survived. Multivariate Logistic regression analysis showed that the use of antibiotics, LUS, sCPIS, respiratory failure, insertion mode, WBC, PCT and hs-CRP were all related influencing factors for VAP in patients(P＜0.05). ROC curve analysis showed that the AUC of LUS and sCPIS for prognostic prediction of VAP was 0.912, and 0.824 respectively. The LUS was 95.9% and 73.1% respectively and the sCPIS was 86.5% and 73.1%, respectively. The accuracy of LUS was higher.ConclusionLUSand sCPIS have good application value in early diagnosis and prognosis evaluation of VAP, and the application value of LUS in prognosis evaluation of VAP patients is higher, which is worthy of promotion and popularization.