超声联合多指标方案在急性呼吸困难病因快速诊断的意义

摘要

目的 探讨超声联合多指标(LCIBX)方案在急性呼吸困难病因快速诊断的意义.方法 急性呼吸困难患者582例分为试验组(LCIBX方案,295例)和对照组(常规经验性处置,287例),比较两组疾病诊断效能的差异,并采用ROC曲线判断LCIBX方案对疾病诊断的灵敏度和特异度.结果 试验组诊断时间为(47.39±27.14)min,短于对照组的(63.57±30.45)min(P＜0.05).两组诊断时间在气胸、胸腔积液、心包积液、慢性阻塞性肺疾病急性加重期(AECOPD)、肺栓塞及肺外型急性呼吸窘迫综合征比较均有统计学差异(P＜0.05).试验组对气胸、胸腔积液、心源性肺水肿和AECOPD的诊断效能优于对照组(P＜0.05).采用LCIBX方案对各病因诊断的灵敏度为87.5％～98.8％,特异度为87.5％～93.3％(P＜0.05).灵敏度最高病因是AECOPD和胸腔积液,最低是气胸.特异度最高病因是胸腔积液,最低是AECOPD.结论 LCIBX方案对急性呼吸困难患者进行病因筛查时,诊断迅速,诊断正确率高,适合在急诊推广使用.%Objective To explore the significance of ultrasound combined with multiple indicators (LCIBX regime) in rapid diagnosis of the patients with acute dyspnea.Methods A total of 582 patients was divided into groups of A (using LCIBX program, 295 cases) and B (using conventional management, 287 cases).The diagnostic efficiency was compared between two groups.The sensitivity and specificity of LCIBX regime for etiological diagnosis of the patients with acute dyspnea were analyzed by ROC curve analysis.Results The time spent on the diagnosis was shorter in group A than that in group B [ (47.39±27.14) minutes vs. (63.57±30.45) minutes] (P＜0.05).There were significant differences in finding etiological factors, such as pneumothorax, pleural effusion, pericardial effusion and acute exacerbation of chronic obstructive pulmonary disease (AECOPD) between two groups (P＜0.05).Diagnostic value for the pneumothorax, pleural effusion, cardiac pulmonary edema and AECOPD was better in group A than that in group B (P＜0.05).The sensitivity and specificity of LCIBX regime in the diagnosis of acute dyspnea with different etiological factors were 87.5％-98.8％ and 87.5％-93.3％, respectively (P＜0.05), in which the most sensitive etiological factor was AECOPD and the most specific etiological factor was pleural effusion.ConclusionFor screening the etiological factors for acute dyspnea, the LCIBX regime has the advantages of rapid diagnosis, high diagnostic accuracy and suitable for popularization in emergency department.