高级检索

床旁超声对重症肺炎患者病情严重程度及预后的评估价值

Value of bedside ultrasound in evaluating disease severity and prognosis of patients with severe pneumonia

    摘要
  • 摘要:
    目的 探讨床旁超声评估重症肺炎(SP)患者病情严重程度及预后的价值。
    方法 回顾性分析急诊重症监护室(EICU)和重症监护室(ICU)收治的120例SP患者的临床资料，患者入院后均接受床旁超声检查与肺部超声评分(LUS)评估。检测患者入院时血清降钙素原(PCT)、C反应蛋白(CRP)、动脉血乳酸(Lac)水平和氧合指数; 根据入院时急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分将患者分为危重组与非危重组，根据出院时预后情况将患者分为预后良好组与预后不良组，比较各组患者LUS与实验室指标水平。分析LUS对SP患者病情严重程度及预后的评估价值。
    结果 140例SP患者中，入院时病情非危重者65例(54.17%)、病情危重者55例(45.83%), 出院时预后良好者94例(78.33%)、预后不良者26例(21.67%)。危重组LUS和PCT、CRP、Lac水平均高于非危重组，入院时氧合指数低于非危重组，差异有统计学意义(P < 0.05); 预后不良组LUS和PCT、CRP、Lac水平均高于预后良好组，氧合指数低于预后良好组，差异有统计学意义(P < 0.05)。Pearson相关分析结果显示, SP患者LUS与PCT、CRP、Lac均呈正相关(r=0.250、0.412、0.315, P < 0.05), 与氧合指数呈负相关(r=-0.235, P < 0.05); 受试者工作特征(ROC)曲线显示, LUS评估SP患者病情危重、预后不良的曲线下面积(AUC)分别为0.894、0.897, 具有一定评估价值。
    结论 床旁超声在SP患者病情严重程度及预后的评估中具有较高的价值。

     

    Abstract:
    Objective To explore the value of bedside ultrasound in evaluating the disease severity and prognosis of patients with severe pneumonia (SP).
    Methods The clinical data of 120 patients with SP admitted to the emergency intensive care unit (EICU) and intensive care unit (ICU) were retrospectively analyzed. All patients underwent bedside ultrasound after admission, and the pulmonary ultrasound score (LUS) was performed. Serum procalcitonin (PCT), C-reactive protein (CRP), arterial blood lactic acid(Lac) and oxygenation index of patients at admission were measured. The patients were divided into critical group and non-critical group according to the Acute Physiology and Chronic Health Status Scoring System Ⅱ (APACHEⅡ) score at admission, and were divided into good prognosis group and poor prognosis group according to prognosis at discharge. LUS and laboratory indexes were compared in each group. The value of LUS in evaluating the severity and prognosis of SP patients was analyzed.
    Results Among the 140 SP patients, 65 patients (54.17%) were not in critical condition at admission, 55 patients (45.83%) were in critical condition, 94 patients (78.33%) had good prognosis at discharge, and 26 patients (21.67%) had poor prognosis. The levels of LUS, PCT, CRP and Lac in the critical group were higher than those in the non-critical group, and the oxygenation index on admission was lower than that in the non-critical group (P < 0.05). The levels of LUS, PCT, CRP and Lac in the poor prognosis group were higher than those in the good prognosis group, and the value of oxygenation index was lower than that in the good prognosis group (P < 0.05). Pearson correlation analysis showed that LUS of SP patients was positively correlated with PCT, CRP and Lac(r=0.250, 0.412, 0.315, P < 0.05), was negatively correlated with oxygenation index (r=-0.235, P < 0.05). Receiver Operating Characteristic (ROC) curve showed that the area under the curve (AUC) of critical condition and poor prognosis of SP patients evaluated by LUS were 0.894 and 0.897 respectively, which had a certain value.
    Conclusion Bedside ultrasound has high value in evaluating the severity and prognosis of SP patients.

     

    • HTML全文
    • 参考文献(19)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回