ICU床旁B超对气胸的诊断价值

摘要

Objective To explore and discuss the clinical application value of bedside B-mode ultrasound in ICU for diagnosing and treating pneumothorax.Methods76 patients with suspicious pneumothorax in the hospital’s ICU were examined by bedside B-mode ultrasound,supine chest X-ray and thoracic CT.The thoracic CT examination was the gold standard for diagnosing pneumothorax.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of pneumothorax were compared between bedside B-mode ultrasound and chest X-ray. Results There had no statistical differences among B-mode ultrasound,X-ray and CT in diagnosis,the sensitivity,specificity, positive predictive value,negative positive value and accuracy of B-mode ultrasound and X-ray had no differences. But the time required of B-mode ultrasound and X-ray had statistically significant difference.Conclusion There had no significant differences between bedside B-mode ultrasound and chest X-ray examination for diagnosing pneumothorax,but bedside B-mode ultrasound had the fast,convenient and real-time characteristics,which was further worthy of clinical promotion.%目的：探讨在ICU病房中床旁B超对气胸诊治中的临床应用价值。方法对我院ICU收治的怀疑气胸患者76例，均进行床旁B超、平卧位胸部X片、胸部CT检查。以胸部CT检查为诊断气胸的金标准。对比床旁B超及胸部X线片对气胸的敏感性、特异性、阳性预测值、阴性预测值、准确度。结果 B超、X线、CT在诊断上差异无统计学意义，B超与X光在敏感性、特异性、阳性预测值、阴性预测值、准确度上无差异。但是B超在所需时间上与X光及CT差异有统计学意义。结论床旁B超与胸部X线片检查在对于诊断气胸无显著差异，但床旁B超具有快捷、方便、实时的特点，所以值得临床推广。