<trans-title xml:lang="en"/>_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

康慧 ¹ , 曹舸 ¹ ,  楊建 ¹ , 張爾永 ¹ , 尹萬紅 ² , 鐘曉緋 ³ , 紀琳 ⁴

1. ;
2. ;
3. ;
4. ;

Corresponding?author：

楊建, Email: ak8328@163.com

Keywords：

肺實變; 肺不張; 床旁肺部超聲; 診斷

DOI：

10.7507/1007-4848.201604060

Video：

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目的探討床旁肺部超聲對心臟術后早期肺實變和肺不張的診斷準確性。方法選取 2014 年 9 月至 2015 年 8 月四川大學華西醫院心臟大血管外科行心臟大血管手術（包括冠狀動脈旁路移植術、瓣膜置換術等）后 1 周之內出現呼吸衰竭的 49 例患者，其中男 24 例、女 25 例，年齡（54.4±13.2）歲。收集患者術后床旁肺部超聲及胸部 CT 檢查結果，進行對照、分析、總結。結果在肺實變和肺不張的診斷中，胸部 CT 診斷 47 例（95.9%）患者為陽性，肺部超聲評估方案（BLUE方案）診斷 45 例（91.8%）患者為陽性，床旁肺部超聲與胸部 CT 診斷一致率為 95.9%。結論床旁肺部超聲可作為篩查肺實變和肺不張的方法。

Citation： 康慧, 曹舸, 楊建, 張爾永, 尹萬紅, 鐘曉緋, 紀琳. . Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(2): 162-165. doi: 10.7507/1007-4848.201604060 Copy

1.	?Self WH, Courtney DM, McNaughton CD, et al. High discordance of chest x-ray and computed tomography for detection of pulmonary opacities in ED patients: implications for diagnosing pneumonia. Am J Emerg Med, 2013, 3(2): 401-405.
2.	Nazerian P, Volpicelli G, Vanni S, et al. Accuracy of lung ultrasound for the diagnosis of consolidations when compared to chest computed tomography. Am J Emerg Med, 2015, 33(5): 620-625.
3.	Cortellaro F, Colombo S, Coen D, et al. Lung ultrasound is an accurate diagnostic tool for the diagnosis of pneumonia in the emergency department. Emerg Med J, 2012, 29(1): 19-23.
4.	Reissig A, Copetti R, Mathis G, et al. Lung ultrasound in the diagnosis and follow-up of community-acquired pneumonia: a prospective, multicenter, diagnostic accuracy study. Chest, 2012, 142(4): 965-972.
5.	Le Neindre A, Mongodi S, Philippart F, et al. Thoracic ultrasound: Potential new tool for physiotherapists in respiratory management. A narrative review. J Crit Care, 2016, 31(1): 101-109.
6.	Lichtenstein DA, Mezière GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest, 2008, 134(1): 117-125.
7.	Cai H, Gong H, Zhang L, et al. Effect of low tidal volume ventilation on atelectasis in patients during general anesthesia: a computed tomographic scan. J Clin Anesth, 2007, 19(2): 125-129.
8.	蒲虹, 黃曉波. 重組人腦利鈉肽治療非體外循環冠狀動脈旁路移植術后撤呼吸機困難的療效分析. 中國胸心血管外科臨床雜志, 2014, 21(4): 554-556.
9.	Lefcoe MS, Fox GA, Leasa DJ, et al. Accuracy of portable chest radiography in the critical care setting. Diagnosis of pneumonia based on quantitative cultures obtained from protected brush catheter. Chest, 1994, 105(3): 885-887.
10.	Lichtenstein DA, Lascols N, Meziere G, et al. Ultrasound diagnosis of alveolar consolidation in the critically ill. Intensive Care Med, 2004, 30(2): 276-281.
11.	Xirouchaki N, Kondili E, Prinianakis G, et al. Impact of lung ultrasound on clinical decision making in critically ill patients. Intensive Care Med, 2014, 40(1): 57-65.
12.	Lichtenstein D, Goldstein I, Mourgeon E, et al. Comparative diagnostic performances of auscultation, chest radiography, and lung ultrasonography in acute respiratory distress syndrome. Anesthesiology, 2004, 100(1): 9-15.
13.	Zanobetti M, Poggioni C, Pini R. Can chest ultrasonography replace standard chest radiography for evaluation of acute dyspnea in the ED? Chest, 2011, 139(5): 1140-1147.
14.	王小亭, 劉大為, 張宏民, 等. 改良床旁肺部超聲評估方案對重癥患者肺實變和肺不張的診斷價值. 中華內科雜志, 2012, 51(12): 948-951.
15.	Hew M, Corcoran JP, Harriss EK, et al. The diagnostic accuracy of chest ultrasound for CT-detected radiographic consolidation in hospitalised adults with acute respiratory failure: a systematic review. BMJ Open, 2015, 5(5): e007838.
16.	Volpicelli G, Elbarbary M, Blaivas M, et al. International liaison committee on lung ultrasound for international consensus conference on lung ultrasound. International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med, 2012, 38(4): 577-591.

1. ?Self WH, Courtney DM, McNaughton CD, et al. High discordance of chest x-ray and computed tomography for detection of pulmonary opacities in ED patients: implications for diagnosing pneumonia. Am J Emerg Med, 2013, 3(2): 401-405.
2. Nazerian P, Volpicelli G, Vanni S, et al. Accuracy of lung ultrasound for the diagnosis of consolidations when compared to chest computed tomography. Am J Emerg Med, 2015, 33(5): 620-625.
3. Cortellaro F, Colombo S, Coen D, et al. Lung ultrasound is an accurate diagnostic tool for the diagnosis of pneumonia in the emergency department. Emerg Med J, 2012, 29(1): 19-23.
4. Reissig A, Copetti R, Mathis G, et al. Lung ultrasound in the diagnosis and follow-up of community-acquired pneumonia: a prospective, multicenter, diagnostic accuracy study. Chest, 2012, 142(4): 965-972.
5. Le Neindre A, Mongodi S, Philippart F, et al. Thoracic ultrasound: Potential new tool for physiotherapists in respiratory management. A narrative review. J Crit Care, 2016, 31(1): 101-109.
6. Lichtenstein DA, Mezière GA. Relevance of lung ultrasound in the diagnosis of acute respiratory failure: the BLUE protocol. Chest, 2008, 134(1): 117-125.
7. Cai H, Gong H, Zhang L, et al. Effect of low tidal volume ventilation on atelectasis in patients during general anesthesia: a computed tomographic scan. J Clin Anesth, 2007, 19(2): 125-129.
8. 蒲虹, 黃曉波. 重組人腦利鈉肽治療非體外循環冠狀動脈旁路移植術后撤呼吸機困難的療效分析. 中國胸心血管外科臨床雜志, 2014, 21(4): 554-556.
9. Lefcoe MS, Fox GA, Leasa DJ, et al. Accuracy of portable chest radiography in the critical care setting. Diagnosis of pneumonia based on quantitative cultures obtained from protected brush catheter. Chest, 1994, 105(3): 885-887.
10. Lichtenstein DA, Lascols N, Meziere G, et al. Ultrasound diagnosis of alveolar consolidation in the critically ill. Intensive Care Med, 2004, 30(2): 276-281.
11. Xirouchaki N, Kondili E, Prinianakis G, et al. Impact of lung ultrasound on clinical decision making in critically ill patients. Intensive Care Med, 2014, 40(1): 57-65.
12. Lichtenstein D, Goldstein I, Mourgeon E, et al. Comparative diagnostic performances of auscultation, chest radiography, and lung ultrasonography in acute respiratory distress syndrome. Anesthesiology, 2004, 100(1): 9-15.
13. Zanobetti M, Poggioni C, Pini R. Can chest ultrasonography replace standard chest radiography for evaluation of acute dyspnea in the ED? Chest, 2011, 139(5): 1140-1147.
14. 王小亭, 劉大為, 張宏民, 等. 改良床旁肺部超聲評估方案對重癥患者肺實變和肺不張的診斷價值. 中華內科雜志, 2012, 51(12): 948-951.
15. Hew M, Corcoran JP, Harriss EK, et al. The diagnostic accuracy of chest ultrasound for CT-detected radiographic consolidation in hospitalised adults with acute respiratory failure: a systematic review. BMJ Open, 2015, 5(5): e007838.
16. Volpicelli G, Elbarbary M, Blaivas M, et al. International liaison committee on lung ultrasound for international consensus conference on lung ultrasound. International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med, 2012, 38(4): 577-591.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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