目的:本研究旨在阐明根据BLUE方案进行床边胸部超声检查的有效性,并探讨其在急诊服务中优于其他成像方法的优势。
方法:本前瞻性研究共纳入120例因呼吸窘迫进入我院急诊护理部门的患者。在每位患者的BLUE协议中指定的点处,在右侧和左侧半胸部进行了胸部USG。胸膜滑动运动,A线,B线,合并,积液,并单独评估条形码标志的存在。年龄,性别,共病,其他放射学检查结果,实验室发现,最终临床诊断,并记录患者的住院-出院状态.
结果:当对肺炎的正确诊断进行成像技术分析时,胸片诊断率为83.3%,CT为100.0%,USG为66.6%。胸部X线检查的正确诊断率为94.5%;CT和USG为100.0%。胸片对肺水肿的正确诊断为94.5%;CT和USG为100.0%。胸部X线和CT对胸腔积液的正确诊断为100.0%。USG成像中为92.3%.最后,气胸患者的CT和USG成像优于胸部X线摄影(胸部X线摄影80.0%,CT和USG100%)。
结论:USG成像可作为诊断肺炎的首选,肺水肿,胸腔积液,气胸,肺栓塞,和急诊服务的鉴别诊断。
OBJECTIVE: This study aimed to elucidate the effectiveness of bedside thoracic ultrasound according to BLUE protocol and to investigate its superiority over other imaging methods in the emergency service.
METHODS: A total of 120 patients admitted to our institution\'s emergency care department due to respiratory distress have been enrolled in this prospective research. Thorax USG has been performed in the right and left hemithorax at the points specified in the BLUE protocol for each patient. Pleural sliding motion, A-lines, B-lines, consolidation, effusion, and the presence of barcode signs were evaluated individually. Age, sex, comorbid diseases, other radiological examination findings, laboratory findings, final clinical diagnosis, and hospitalization-discharge status of the patients were recorded.
RESULTS: When a correct diagnosis of pneumonia has been analyzed for imaging techniques, the diagnostic rate of chest radiography was 83.3%, CT was 100.0%, and USG was 66.6%. The correct diagnostic rate of chest radiography was 94.5%; CT and USG were 100.0%. The correct diagnosis of pulmonary edema on chest radiography was 94.5%; CT and USG were 100.0%. While the correct diagnosis of pleural effusion on chest radiography and CT was 100.0%, it was 92.3% in USG imaging. Finally, CT and USG imaging performed better than chest radiography in patients with pneumothorax (chest radiography 80.0%, CT and USG 100%).
CONCLUSIONS: USG imaging could be preferred in the diagnosis of pneumonia, pulmonary edema, pleural effusion, pneumothorax, pulmonary embolism, and differential diagnosis at the emergency service.