床旁超声对急诊重症监护病房机械通气合并气胸患者的应用价值

目的 通过床旁超声在急诊重症监护病房（EICU）机械通气合并气胸患者诊治中的应用研究，探讨危重气胸患者更快捷、安全、可靠的诊断方法。方法 对入住EICU高度怀疑机械通气合并气胸的57例患者，分别进行床旁超声、床旁胸片与胸部CT检查，对各种检查方法诊断所需时间、诊断灵敏度、特异度、正确率进行分析。结果 床旁超声、床旁胸片、胸部CT 3种方法诊断耗时分别为（5.05±1.91） min、（16.04±3.73） min、（22.55±3.52） min，床旁超声诊断耗时最短（P＜0.01）；床旁超声与胸部CT对气胸的诊断一致性（Kappa=0.930）明显优于床旁胸片与胸部CT的诊断一致性（Kappa=0.444）。结论 床旁超声在EICU机械通气合并气胸患者诊治中高效快捷，有较高应用价值。

Application value of bedside ultrasound on EICU patients with mechanical ventilation combined with pneumothorax

Objective To discuss the diagnosis method in critical patients with mechanical ventilation and pneumothorax by ultrasound in emergency intensive care unit（EICU）.Methods For 57 patients with highly suspicious of mechanical ventilation combined with pneumothorax admitted to EICU， the diagnosis was performed by bedside pultrasound， bedside chest X ray and chest CT. Analysis of various inspection methods were performed in the time needed for diagnosis， diagnostic sensitivity， specificity and accuracy. Results The diagnostic time in bedside ultrasound， bedside chest X ray and chest CT was (5.05±1.91) min， (16.04±3.73) min and (22.55±3.52) min， respectively; the shortest diagnosis time was done by bedside ultrasound （P<0.01）. Kappa value by bedside pulmonary ultrasound and bedside chest CT was 0.930， Kappa value by bedside chest X ray and bedside chest CT was 0.444， bedside ultrasound was obviously better than bedside chest X ray. Conclusion The bedside ultrasound has a high value and efficiency in the diagnosis of mechanical ventilation combined with pneumothorax in EICU patients.