床旁肺超声在肺部感染灶解剖定位及大小判断中的应用

目的 虽然有CT、床旁X线摄片等技术来诊断肺部感染,但临床上仍迫切需要一种便捷、有效、易于重复的床旁检查来精确判断肺部感染患者,特别是危重患者肺部感染病灶的解剖部位和大小。当前肺超声在临床上的应用日益受到重视,其具有安全无放射线,方便快捷,可反复多次检查、实时成像并获得结果,检查费用低的优点。本文目的是探讨床旁肺超声在肺部感染灶解剖定位及大小判断中的应用。 方法 在对健康人群进行肺超声扫查,熟悉超声图中肺的解剖学定位的基础上,对2015年1月至2019年1月在南通大学附属医院住院的,符合社区获得性肺炎诊断标准的患者40例,于入院时行床旁超声检查的同时行胸部CT扫描,对床旁超声检查和胸部CT检查的肺部感染灶解剖位置进行定位,并对感染灶大小进行量化比较,从而对床旁超声相对于胸部CT扫描在肺炎患者肺部感染灶、解剖定位及大小判断的准确性进行评估。 结果 使用床旁超声对肺组织进行探查可以清晰地显示皮肤、皮下软组织、骨骼及肺叶,结合探头在胸壁的相对位置和扫查方向,可以对肺部感染灶,特别是范围较大的感染灶进行较为准确的解剖学定位,并准确进行大小判断。 结论 床旁肺超声在肺部感染灶解剖定位及大小判断中具有临床应用价值。

Application of bedside pulmonary ultrasound in the anatomical location and size judgement of pulmonary infection focus

Objective Although CT and bedside X-ray are available to diagnose pneumonia, there is still an urgent need for a convenient, effective bedside examination to accurately diagnose pneumonia especially in critically ill patients. The purpose of this study was to explore the application of bedside pulmonary ultrasound in the anatomical location and size determination of pneumonia. Methods Familiarizing pulmonary anatomical localization of healthy people with pulmonary ultrasonography, 40 patients with community acquired pneumonia who were hospitalized in the Affiliated Hospital of Nantong University from January 2015 to January 2019 met the diagnostic criteria of community acquired pneumonia were examined by bedside ultrasonography and chest CT scan at the time of admission. The anatomical location of pulmonary inflammatory lesions was localized and the size of the infected lesions was quantitatively compared. Results Bedside ultrasound can clearly display pulmonary anatomical localization and accurately determine the size of pulmonary infected lesions. Conclusion Bedside pulmonary ultrasonography has clinical application value in the anatomical location and size judgement of pulmonary infection focus.