肺超声在成人社区获得性肺炎诊断和随访中的应用价值

崔丽清; 何琳; 谢敏; 谢涛

doi:10.16016/j.1000-5404.201803229

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肺超声在成人社区获得性肺炎诊断和随访中的应用价值

临床医学 | 更新时间：2026-01-09

- 肺超声在成人社区获得性肺炎诊断和随访中的应用价值
- Value of lung ultrasound in diagnosis and follow-up of community-acquired pneumonia in adult patients
- 第三军医大学学报 2018年40卷第18期页码：1699-1703
- 作者机构：
  
  401331 重庆，重庆医科大学附属大学城医院超声科
- 作者简介：
  
  [ 何琳，E-mail: 2452256138@qq.com HE Lin, E-mail: 2452256138@qq.com
- 基金信息：
  
  重庆市卫生和计划生育委员会2017年度中医药科技项目(ZY201703033)
- DOI：10.16016/j.1000-5404.201803229
  中图分类号： R445.1;R563.1
- 收稿：2018-03-06，
  
  修回：2018-05-29，
  
  纸质出版：2018-09-30
- 稿件说明：
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崔丽清, 何琳, 谢敏, 等. 肺超声在成人社区获得性肺炎诊断和随访中的应用价值[J]. 第三军医大学学报, 2018,40(18):1699-1703.

Liqing Cui, Lin He, Min Xie, et al. Value of lung ultrasound in diagnosis and follow-up of community-acquired pneumonia in adult patients[J]. Journal of Third Military Medical University, 2018, 40(18): 1699-1703.
崔丽清, 何琳, 谢敏, 等. 肺超声在成人社区获得性肺炎诊断和随访中的应用价值[J]. 第三军医大学学报, 2018,40(18):1699-1703. DOI： 10.16016/j.1000-5404.201803229.

Liqing Cui, Lin He, Min Xie, et al. Value of lung ultrasound in diagnosis and follow-up of community-acquired pneumonia in adult patients[J]. Journal of Third Military Medical University, 2018, 40(18): 1699-1703. DOI： 10.16016/j.1000-5404.201803229.

摘要

目的

明确肺超声在成人社区获得性肺炎诊断中的准确性及随访的可行性。

方法

对2017年2-12月我院呼吸科39例疑诊社区获得性肺炎患者同时行肺超声和胸部CT检查(“金标准”对照)，分析肺超声对社区获得性肺炎的诊断价值。肺超声的随访在治疗第5～7天、第10～14天进行，评估肺实变位置、实变范围、空气支气管征和胸腔积液的比例。

结果

39例患者中经胸部CT诊断社区获得性肺炎31例，经肺超声诊断社区获得性肺炎28例。肺超声诊断肺炎的敏感性为90.3%，特异性为87.5%，肺超声诊断肺炎的阳性预测值为96.6%，阴性预测值为70%；超声诊断显示82.1%患者空气支气管征阳性，35.7%患者胸腔积液。在治疗第10～14天，病灶面积中位数由8.75 cm

降至2.65 cm

，病灶面积变化差异有统计学意义(

0.05)；空气支气管征比例从82.1%降至62.5%，胸腔积液比例从35.7%至完全消失。

结论

肺超声诊断社区获得性肺炎准确率高，能动态实时观察病灶变化，是一种无创的、重复性好的、可靠的检查手段，可用于成人社区获得性肺炎的诊断和随访。

Abstract

Objective

To investigate the diagnostic accuracy of lung ultrasound (LUS) for community acquired pneumonia (CAP) in adult patients and the value of LUS in the follow-up of the patients.

Methods

Thirty-nine adult patients with a suspected diagnosis of CAP in our respiratory center underwent examinations with both LUS and chest computed tomography (CT). With the CT findings as the gold standard for diagnosing CAP

we analyzed the diagnostic value of LUS in CAP. Follow-up LUS examinations were performed for these patients during days 5 to 7 and days 10 to 14 of the treatment to evaluate the position and range of lung consolidation

the presence of air bronchogram

and the changes in pleural effusion.

Results

Of the 39 patients with a suspe

cted diagnosis

31 had an established diagnosis of CAP by chest CT

and 28 had a definite diagnosis by LUS. The diagnostic sensitivity of LUS for pneumonia in these patients was 90.3%

with a diagnostic specificity of 87.5%

a positive predictive value of 96.6%

and a negative predictive value of 70%. Of the 31 patients with a definite diagnosis of CAP

82.1% presented with air bronchogram and 35.7% had pleural effusion based on the findings by LUS. In 10 to 14 days during the treatment

the median area of the lesion was reduced significantly from 8.75 cm to 2.65 cm (

0.05)

the percentage of patients with air bronchogram decreased from 82.1% to 62.5%

and pleural effusion completely disappeared in all the patients.

Conclusion

LUS has a high diagnostic accuracy for CAP and allows dynamic observation of the changes of the pulmonary lesions. As a noninvasive modality with a good repeatability and reliability

LUS can be used for the diagnosis and follow-up of CAP in adult patients.

关键词

Keywords

references

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