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| 肺部超声在新冠肺炎重症患者中的应用 |
| Experience in lung ultrasound in critically ill patients with COVID-19 pneumonia |
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| DOI：10.12089/jca.2020.06.015 |
| 中文关键词: 新型冠状病毒肺炎 肺部超声 临床特征 急性呼吸窘迫综合征 |
| 英文关键词: Coronavirus disease 2019 Lung ultrasound Clinical features Acute respiratory distress syndrome |
| 基金项目: |
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| 中文摘要: |
目的 总结疫情一线麻醉科医师将肺部超声用于新型冠状病毒肺炎（COVID-19）重症患者的评估效果。
方法 回顾性分析2020年2月10日至3月12日在武汉火神山医院重症一科ICU内接受治疗的50例COVID-19重症患者的临床资料及床旁肺部超声检查结果。
结果 50例COVID-19重症患者年龄（70.3±9.0）岁，初始症状是咳嗽（100%）、发热（100%）和呼吸困难（24%）。入院后28 d的死亡率为30%。ICU内床旁肺部超声检查可发现不同程度的超声学病理征象，包括胸膜异常，间质综合征、肺实变、胸腔积液、碎片征和动态支气管征象等。在ICU治疗期间存活的患者肺超声评分（LUS）（12.8±4.4）分，非存活者具有持续的肺水肿和肺实变超声表现，LUS（21.0±3.5）分，明显高于存活患者（P<0.05）。15例非存活患者全部发生急性呼吸窘迫综合征（ARDS）并接受有创机械通气（IMV），其中ImV治疗3 d时LUS（22.0±1.9）分，5 d时LUS（24.2±2.6）分。随着患者康复并转出ICU，病理性的超声征象呈现逐步减少趋势。
结论 床旁肺部超声具有简便易行及动态监测的优势，对COVID-19重症肺炎患者疗效的评估具有积极意义。 |
| 英文摘要: |
Ojective To summarize the value of evaluating pulmonary disease progression in coronavirus disease 2019 (COVID-19) patient by Doppler ultrasound.
Methods The clinical data of 50 patients treated in the intensive care unit (ICU) of Huoshenshan Hospital (Wuhan, China) between February 10 and March 12, 2020 were reviewed.
Results The average age of patients with COVID-19 severe pneumonia was (70.3 ± 9.0) years old, with initial symptoms being cough (100%), fever (100%) and dyspnea (24%). The mortality rate for 28 days was 30%. Lung ultrasound examination next to the bed in the ICU can find different degrees of ultrasound pathological signs, including plexisome, interstitial syndrome, pulmonary real change, thoracic fluid, debris and dynamic static bronchial signs. The pulmonary ultrasound score (LUS) of patients who survived during ICU treatment was (12.8 ± 4.4) scores, non-survivors had persistent pulmonary edema and pulmonary actual ultrasound performance, and pulmonary ultrasound score (LUS) was (21.0 ± 3.5) scores. All 15 non survivor patients had acute respiratory distress syndrome (ARDS) and received invasive mechanical ventilation (IMV), of which the LUS value on the 3rd day was (22.0 ± 1.9) scores and the 5th day was (24.2 ± 2.6) scores, indicating an increase in lung damage. With the recovery of patients and transfer out of ICU, the signs of disease-rational ultrasound show a gradual decrease trend.
Conclusion Lung ultrasound by bed has the advantages of simple and dynamic monitoring, and has positive significance for the evaluation of the efficacy of patients with COVID-19 severe pneumonia. |
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