标题：急诊床旁肺部超声在气胸患者快速诊断中的应用

      作者：鄢涛 1，谢雯雯 2，刘小琴 1，姜伟 1，杨勇 1，余函阳 1，李芝霖 1，巫金 1，阳毅 1，    唐一男 1，杨南岚 1，唐小曲 1，廖春燕 1，陈熙 11.德阳市人民医院急诊科，四川 德阳 618000；2.绵阳市第三人民医院，四川 绵阳 621000

      卷次： 2019年30卷7期

      【摘要】 目的 探讨急诊床旁肺部超声在气胸患者快速诊断中的应用价值。方法 回顾性分析德阳市人民医院急诊科2017年8月至2018年8月急诊接诊的103例疑似诊断气胸患者的临床资料，所有患者均进行急诊床旁肺超声检查和急诊胸部CT检查。比较两种检查方法的转运时间、检查报告时间、费用、诊断效率、检查方法一致性，并对肺部超声操作者进行问卷调查。结果 103例患者的急诊床旁肺超声转运时间和检查报告时间分别为(0.48±0.11) min和(12.45±5.24) min，明显比急诊胸部CT检查的(10.24±1.88) min和(15.85±2.34) min短，差异均具有统计学意义(P<0.05)；急诊胸部CT费用约为急诊肺部超声的3倍；两种检查方法进行一致性比较，肯德尔和谐系数为0.625 9，两种检查方法具有一致性；急诊床旁肺部超声检查敏感性为91.17% (62/68)，特异性为88.57% (31/35)，准确性90.29% (93/103)。操作者调查问卷显示急诊床旁肺部超声具有快速、易操作、无辐射和便携特点。结论 在临床上快速诊断气胸中，急诊床旁肺部超声检查具有快速、易操作、准确性高、无辐射、便携和费用低的特点，缩短了诊断时间，提高了急救效率，适合在基层医院急诊抢救中推广。
      【关键词】 急诊床旁肺部超声；胸部CT；气胸；急诊急救；基层医院
      【中图分类号】 R561.4 【文献标识码】 A 【文章编号】 1003—6350（2019）07—0885—03

Application of bedside lung ultrasound in emergency for rapid diagnosis of pneumothorax.
YAN Tao 1, XIEWen-wen 2, LIU Xiao-qin 1, JIANG Wei 1, YANG Yong 1, YU Han-yang 1, LI Zhi-lin 1, WU Jin 1, YANG Yi 1, TANG Yi-nan 1,YANG Nan-lan 1, TANG Xiao-qu 1, LIAO Chun-yan 1, CHEN Xi 1. 1. Emergency Department, People's Hospital of DeyangCity, Deyang 618000, Sichuan, CHINA; 2. The Third People's Hospital of Mianyang, Mianyang 621000, Sichuan, CHINA
【Abstract】 Objective To explore the application value of bedside lung ultrasound in emergency for rapid diag-nosis of pneumothorax. Methods The clinical data of 103 suspected pneumothorax patients admitted to the EmergencyDepartment at People's Hospital of Deyang City from August 2017 to August 2018 were retrospectively analyzed, and allpatients underwent beside lung ultrasound and chest CT scan in emergency. The patients’transfer time, inspection reporttime, cost, diagnostic efficiency, and consistency of inspection methods were compared between the two methods, and aquestionnaire survey was conducted on the operators of bedside lung ultrasound in emergency. Results The patients'transport time and inspection report time of 103 patients who underwent bedside lung ultrasound in emergency wererespectively (0.48 ± 0.11) minutes and (12.45 ± 5.24) minutes, which were significantly shorter than corresponding(10.24±1.88) minutes and (15.85±2.34) minutes of patients who underwent bedside chest CT scan in emergency (P<0.05). The cost of chest CT in emergency was about three times that of beside lung ultrasound. Consistent comparison ofthe two inspection methods, the Kendall Harmony Coefficient was 0.6259, then the two methods were consistent. Thesensitivity, specificity, and accuracy of bedside ultrasound in emergency were respectively 91.17% (62/68), 88.57%(31/35), and 90.29% (93/103). The operator questionnaire showed that bedside lung ultrasound in emergency has thecharacteristics of rapid diagnosis, easy operation, no radiation and portability. Conclusion In clinical rapid diagnosisof pneumothorax, bedside lung ultrasonography in emergency has the characteristics of fast, easy operation, high accura-cy, no radiation, portability and low cost, which shortens the diagnosis time, and improves the efficiency of emergencytreatment, and is suitable for promotion in emergency rescue in primary hospitals.
      【Key words】 Bedside lung ultrasound in emergency; Chest CT; Pneumothorax; Emergency rescue; Primary hos-pital·短篇论著·doi:10.3969/j.issn.1003-6350.2019.07.021基金项目：四川省教育厅资助项目(编号：SWFZ16)