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1、•临床研究•床旁超声和胸部x线检查在重症肺炎诊断中的临床对比观察张山红张洪波刘笑雷张国强【摘要】目的分析重症肺炎患者的肺部超声特征，探讨床旁超声诊断肺炎的临床价值。方法以急诊留院治疗的疑诊重症肺炎患者为研究对象，对患者进行胸部X线检奄(chestx-rayCXR)、肺部超声检査及胸部CT检査；分析床旁超声诊断巫症肺炎的敏感性、特异性、阳性预测值、阴性预测值及准确性，并与CXR进彳j比较。结果虽症肺炎组出现肺实变的患者例数、仓胸脫改变的肋间个数、胸膜下病变个数以及合并有胸腔积液的患者例数均髙于非重症肺炎组。床旁超声诊断重症肺炎的敏感性为95.7%，特异性为97.1%,
2、阳性预测值为98.5%，阴性预测值为89.5%,准确性为96.2%。与CXR比较，两者在敏感性、阴性预测值和准确性上差异具有统计学意义。结论床旁超声是诊断重症肺炎可靠的辅助检査方法，诊断的敏感性、明性预测值和准确性优于CXR，广泛地开展胸部床旁超声检查可以提高重症肺炎的快速诊断，确立及时正确的治疗。【关键词】超声检查；胸部X线检查；甫症肺炎Comparisonofdiagnosticperformancesbetweenbedsidesonographyandchestx-rayinseverepneumoniaZ/MNGShanhong,ZHANGHongbo，L
3、IUXiaolei,ZHANGGuoqiang.EmergencyDepartment,China-JapanFriendshipHospital,Beijing100029,ChinaCorrespondingauthor:ZhangHongbo，Email:jhzhb@126.com【Abstract】ObjectiveToevaluatethediagnosticperformancesofbedsidelungultrasound(US)andchestradiography(CXR)inpatientswithseverepneumonia.MethodL
4、ungultrasound(US),CXRandchestCTwereperformedinsequenceinadultpatientsadmittedtotheemergencydepartmentforsuspectedacuterespiratoryfailurecausedbyseverepneumonia.Here,chestCTservedasa”goldedstandard"forcomparison.ThediagnosticefficacyofUSforthedetectionofseverepneumonia,definedasrapidity
5、andaccuracy(sensitivity,specificity,positivepredictivevalue,negativepredictivevalue)werecomparedwithCXR.ResultsThenumberofpatientswithconsolidationoflung，pleuralalteration,subpleuralpathologicalchanges,andpleuraleffusionintheseverepneumoniagroupwashigherthanthatinthenon-pneurnoniagroup
6、.Sensitivityofbedsideultrasoundexaminationforthediagnosisofseverepneumoniawas95.7%,andspecificity96.3%,positivepredictivevalue95.7%tnegativepredictivevalue96.3%,andaccuracy96.0%•Thereweredifferencesinsensitivity,negativepredictivevalueandaccuracyfoundbetweenCXRandUS.ConclusionsBedsidec
7、hestultrasoundisareliabledeviceforthediagnosisofseverepneumonia,andsuperiortoCXRinthissetting,allowingamorepromptdiagnosisandtreatment.[Keywords】Ultrasonicinspection；ChestX-ray;Severepneumonia1)01:10.3760/cma.j.issn.1671-0282.2014.12.015基金项0:国家临床重点专科建没项0;留学人员科技活动项H择优资助作者单位：100029北京，中
