摘要
目的分析慢性心力衰竭(心衰)急性发作患者使用床旁心脏超声进行紧急临床诊断的诊断效能。方法研究对象选择疑似慢性心衰急性发作患者110例,均实施常规检查、床旁心脏超声检查,分析检查结果,以临床诊断为金标准,比较两种检查方式的诊断灵敏度、特异度、准确率、阳性预测值、阴性预测值、误诊率、漏诊率、诊断用时、检查用时。结果110例疑似慢性心衰急性发作患者经临床诊断确诊105例,占比95.45%,床旁心脏超声检查的阳性检出率为92.73%(102/110),高于常规检查的80.91%(89/110),差异性明显(χ^(2)=6.712,P=0.010<0.05)。以临床诊断为金标准,床旁心脏超声检查的诊断灵敏度96.19%(101/105)、准确率95.45%(105/110)均高于常规检查的80.95%(85/105)、78.18%(86/110),差异性明显(P<0.05);两种检查方式的诊断特异度比较,差异性不明显(P>0.05);床旁心脏超声检查的阴性预测值50.00%(4/8)高于常规检查的4.76%(1/21),差异性明显(P<0.05);两种检查方式的阳性预测值比较差异性不明显(P>0.05);床旁心脏超声检查的漏诊率3.81%(4/105)低于常规检查的19.05%(20/105),差异性明显(P<0.05);两种检查方式的误诊率比较差异性不明显(P>0.05)。床旁心脏超声检查的诊断用时(21.01±6.07)min短于常规检查的(46.83±10.85)min,检查反应用时(10.31±4.87)min、检查操作时间(13.26±1.17)min长于常规检查的(6.36±0.13)、(6.05±0.02)min,差异性明显(P<0.05)。结论为慢性心衰急性发作患者使用床旁心脏超声进行紧急临床诊断,具有较高的诊断效能,且诊断用时更短,临床应用价值较高。
Objective To analyze the diagnostic efficiency of bedside cardiac ultrasound in emergency clinical diagnosis of patients with acute exacerbation of chronic heart failure.Methods A total of 110 patients with suspected acute exacerbation of chronic heart failure were selected as subjects,all of whom were subjected to routine examination and bedside cardiac ultrasound,and their examination results were analyzed.Clinical diagnosis was used as the gold standard to compare the diagnostic sensitivity,specificity,accuracy,positive predictive value,negative predictive value,misdiagnosis rate,missed diagnosis rate,diagnostic time,and examination time of the two examination modalities.Results Among 110 suspected patients with acute exacerbation of chronic heart failure,105 cases were clinically diagnosed,accounting for 95.45%.The positive detection rate of bedside cardiac ultrasound was 92.73%(102/110),which was higher than 80.91%(89/110)of routine examination,and the difference was significant(χ2=6.712,P=0.010<0.05).Taking clinical diagnosis as the gold standard,the diagnostic sensitivity of bedside cardiac ultrasound was 96.19%(101/105)and the accuracy rate was 95.45%(105/110),which were higher than 80.95%(85/105)and 78.18%(86/110)of routine examination,and the difference was significant(P<0.05).Comparison of the diagnostic specificity of the two examination modalities showed an insignificant difference(P>0.05).The negative predictive value of bedside cardiac ultrasound was 50.00%(4/8),which was higher than 4.76%(1/21)of routine examination,and the difference was significant(P<0.05).There was no significant difference in positive predictive value between the two examination modalities(P>0.05).The missed diagnosis rate of bedside cardiac ultrasound was 3.81%(4/105),which was lower than 19.05%(20/105)of routine examination,and the difference was significant(P<0.05).There was no significant difference in the misdiagnosis rate between the two examination modalities(P>0.05).The diagnostic time(21.01±6.07)min of bedside cardiac ultrasound was shorter than that of routine examination(46.83±10.85)min;while both the reaction time(10.31±4.87)min and the operation time(13.26±1.17)min were longer compared to routine examination(6.36±0.13)and(6.05±0.02)min,and the difference was significant(P<0.05).Conclusion Bedside cardiac ultrasound for emergency clinical diagnosis of patients with acute exacerbation of chronic heart failure has high diagnostic efficacy and shorter diagnostic time,which is of high clinical application value.
作者
王兰花
李丹
WANG Lan-hua;LI Dan(Echocardiography Room,Liaocheng People's Hospital,Liaocheng 252000,China)
出处
《中国实用医药》
2025年第11期56-59,共4页
China Practical Medicine
关键词
床旁心脏超声
慢性心力衰竭
急性发作
紧急临床诊断
Bedside cardiac ultrasound
Chronic heart failure
Acute exacerbation
Emergency clinical diagnosis
