摘要
目的探讨肺源性急性呼吸窘迫综合征(ARDSp)及肺外源性急性呼吸窘迫综合征(ARDSexp)患者血管外肺水的差异,评估肺超声B线积分对ARDS血管外肺水的诊断价值。方法分析17例ARDSp患者及24例ARDSexp患者的临床资料,确诊第3天,监测两组患者血管外肺水指数(extravascular lungwater index,ELWI)和肺超声B线积分,并进行相关性分析。确诊第10天,监测两组病情未缓解患者ELWI和肺超声B线积分并进行相关性分析。结果确诊第3天,两组ELWI和肺超声B线积分差异均有统计学意义(P<0.01),ARDSp组ELWI和肺超声B线积分高于ARDSexp组。确诊第10天,两组病情未缓解患者ELWI和肺超声B线积分差异无统计学意义(P>0.05)。确诊3天,两组ELWI和肺超声B线积分均呈正相关(r=0.655,r=0.504)。确诊10天,两组病情未缓解患者ELWI和肺超声B线积分也呈正相关(r=0.942,r=0.746)。结论两种不同类型ARDS早期肺水程度不同,肺超声B线积分对肺源性ARDS及非肺源性ARDS血管外肺水均有重要的诊断价值。
Objective:To investigate the difference in extravascular lung water(EVLW)between direct acute respiratory distress syndrome(ARDSp)and indirect acute respiratory distress syndrome(ARDSexp),and to evaluate diagnostic value of lung ultrasound B-line score for pulmonary edema of ARDS.Methods:Seventeen patients with ARDSp and 24 patients with ARDS exp were analyzed.3d after confirmed diagnosis,the extravascular lungwater index(ELWI)and B-line score were monitored in two groups.Relationships between B line and extravascular lung water index(ELWI)were analyzed respectively.10d after confirmed diagnosis ELWI and B-line score were monitored in disremisson case of two groups.Relationships between B line and extravascular lung water index(ELWI)were analyzed respectively.Results:Difference on B line and ELWI in two groups had statistical significance(P<0.05),and B line was positively related to ELWI(r=0.655,r=0.504)in 3d after confirmed diagnosis.There were no difference on B line and ELWI in disremisson case of two groups in 10d after admission,but B line was still positively related to ELWI(r=0.942,r=0.746).Conclusion:Different levels of ELWI in two types of ARDS may suggest the different degree of pulmonary edema in early stage,lung ultrasound B-line score has important diagnostic value for extravascular lung water in ARDSp and ARDSexp.
作者
王梅
于亮
韩卫华
WANG Mei;YU Liang;HAN Wei-hua(Dept.of Ultrasonography,Taian Central Hospital,Taian 271000,China;Respiratory Intensive Care Unit,Taian Central Hospital,Taian 271000,China)
出处
《泰山医学院学报》
CAS
2020年第1期22-25,共4页
Journal of Taishan Medical College