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

Authors：

康慧 ¹ , 曹舸 ¹ ,  杨建 ¹ , 张尔永 ¹ , 尹万红 ² , 钟晓绯 ³ , 纪琳 ⁴

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

Corresponding author：

杨建, Email: ak8328@163.com

Keywords：

肺实变; 肺不张; 床旁肺部超声; 诊断

DOI：

10.7507/1007-4848.201604060

Video：

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目的探讨床旁肺部超声对心脏术后早期肺实变和肺不张的诊断准确性。方法选取 2014 年 9 月至 2015 年 8 月四川大学华西医院心脏大血管外科行心脏大血管手术（包括冠状动脉旁路移植术、瓣膜置换术等）后 1 周之内出现呼吸衰竭的 49 例患者，其中男 24 例、女 25 例，年龄（54.4±13.2）岁。收集患者术后床旁肺部超声及胸部 CT 检查结果，进行对照、分析、总结。结果在肺实变和肺不张的诊断中，胸部 CT 诊断 47 例（95.9%）患者为阳性，肺部超声评估方案（BLUE方案）诊断 45 例（91.8%）患者为阳性，床旁肺部超声与胸部 CT 诊断一致率为 95.9%。结论床旁肺部超声可作为筛查肺实变和肺不张的方法。

Citation： 康慧, 曹舸, 杨建, 张尔永, 尹万红, 钟晓绯, 纪琳. . 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, 黄晓波. 重组人脑利钠肽治疗非体外循环冠状动脉旁路移植术后撤呼吸机困难的疗效分析. 中国胸心血管外科临床杂志, 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, 刘大为, 张宏民, 等. 改良床旁肺部超声评估方案对重症患者肺实变和肺不张的诊断价值. 中华内科杂志, 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, 黄晓波. 重组人脑利钠肽治疗非体外循环冠状动脉旁路移植术后撤呼吸机困难的疗效分析. 中国胸心血管外科临床杂志, 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, 刘大为, 张宏民, 等. 改良床旁肺部超声评估方案对重症患者肺实变和肺不张的诊断价值. 中华内科杂志, 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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