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CHEST:使用超声检查急性呼吸困难是否可行?

2017-02-25 MedSci MedSci原创

急性呼吸困难是急诊科(ED)的常见症状。呼吸困难的标准治疗途径通常依赖放射学和实验室结果,这可能过度延迟开始治疗时间;集成超声(PoCUS)方法可以缩短诊断所需的时间,维持可接受的安全性。近期,一项发表在杂志CHEST上的文章进行了超声诊断急性呼吸困难的评估研究。ED评估后的成人呼吸困难患者入组。金标准是由两位专家评审员评估的最终诊断。两位医生独立评估患者:超声医师对肺、心脏和下腔静脉进行超声(U

急性呼吸困难是急诊科(ED)的常见症状。呼吸困难的标准治疗途径通常依赖放射学和实验室结果,这可能过度延迟开始治疗时间;集成超声(PoCUS)方法可以缩短诊断所需的时间,维持可接受的安全性。

近期,一项发表在杂志CHEST上的文章进行了超声诊断急性呼吸困难的评估研究。

ED评估后的成人呼吸困难患者入组。金标准是由两位专家评审员评估的最终诊断。两位医生独立评估患者:超声医师对肺、心脏和下腔静脉进行超声(US)评估,同时治疗医生根据需要进行传统测试。记录和比较配制US和ED诊断所需的时间。计算US和ED诊断的准确性和一致性。

此项研究结果显示:共2683例患者入组。制定US诊断所需的平均时间显着低于ED诊断所需的时间(24±10分钟vs 186±72分钟,p = 0.025)。US和ED诊断显示良好的总体一致性(k = 0.71)。冠状动脉综合征,肺炎,胸腔积液,心包积液,气胸和其他原因导致的呼吸困难诊断的PoCUS和标准ED检查的准确性在统计学上没有显着差异; PoCUS对于心力衰竭的诊断更加敏感,而标准ED治疗在慢性阻塞性肺病/哮喘和肺栓塞的诊断中表现更好。

研究表明:PoCUS对呼吸困难患者是一种可行可靠的诊断方法,可以减少诊断时间。

原始出处:
Zanobetti M, Scorpiniti M, et al. Point-of-care ultrasonography for evaluation of acute dyspnea in the emergency department. Chest. 2017 Feb 14. pii: S0012-3692(17)30199-X. doi: 10.1016/j.chest.2017.02.003.

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    2018-03-20 owlhealth

    不错耶.学习了

    0

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    2017-07-14 Smile2680
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  5. [GetPortalCommentsPageByObjectIdResponse(id=298094, encodeId=524029809499, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=2, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Tue Mar 20 17:18:40 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929292, encodeId=c9c71929292e9, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Fri Jul 14 16:24:00 CST 2017, time=2017-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050605, encodeId=29a020506057f, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Thu Aug 17 17:24:00 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1957581, encodeId=1fff195e58140, content=<a href='/topic/show?id=201d5223614' target=_blank style='color:#2F92EE;'>#急性呼吸困难#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52236, encryptionId=201d5223614, topicName=急性呼吸困难)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/TnzXXl41yf6V8fHrDb5JdtxOgpaY6vplUhHtL8BzDh1xMtcap9H1IOlE8umxPGovhIuVkeGTY26eNUFCFaOheQ/132, createdBy=29702500197, createdName=ms6279672939590805, createdTime=Sun Jun 18 16:24:00 CST 2017, time=2017-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281847, encodeId=8553128184e34, content=<a href='/topic/show?id=21753963364' target=_blank style='color:#2F92EE;'>#呼吸困难#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39633, encryptionId=21753963364, topicName=呼吸困难)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Mon Feb 27 11:24:00 CST 2017, time=2017-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1284289, encodeId=d76512842892a, content=<a href='/topic/show?id=d27a9280461' target=_blank style='color:#2F92EE;'>#超声检查#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92804, encryptionId=d27a9280461, topicName=超声检查)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=649f191, createdName=zzc2211, createdTime=Mon Feb 27 11:24:00 CST 2017, time=2017-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=177934, encodeId=ae621e793405, content=应该没有那么可靠, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sun Feb 26 09:22:55 CST 2017, time=2017-02-26, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=298094, encodeId=524029809499, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=2, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Tue Mar 20 17:18:40 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929292, encodeId=c9c71929292e9, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Fri Jul 14 16:24:00 CST 2017, time=2017-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050605, encodeId=29a020506057f, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Thu Aug 17 17:24:00 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1957581, encodeId=1fff195e58140, content=<a href='/topic/show?id=201d5223614' target=_blank style='color:#2F92EE;'>#急性呼吸困难#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52236, encryptionId=201d5223614, topicName=急性呼吸困难)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/TnzXXl41yf6V8fHrDb5JdtxOgpaY6vplUhHtL8BzDh1xMtcap9H1IOlE8umxPGovhIuVkeGTY26eNUFCFaOheQ/132, createdBy=29702500197, createdName=ms6279672939590805, createdTime=Sun Jun 18 16:24:00 CST 2017, time=2017-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281847, encodeId=8553128184e34, content=<a href='/topic/show?id=21753963364' target=_blank style='color:#2F92EE;'>#呼吸困难#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39633, encryptionId=21753963364, topicName=呼吸困难)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Mon Feb 27 11:24:00 CST 2017, time=2017-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1284289, encodeId=d76512842892a, content=<a href='/topic/show?id=d27a9280461' target=_blank style='color:#2F92EE;'>#超声检查#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92804, encryptionId=d27a9280461, topicName=超声检查)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=649f191, createdName=zzc2211, createdTime=Mon Feb 27 11:24:00 CST 2017, time=2017-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=177934, encodeId=ae621e793405, content=应该没有那么可靠, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sun Feb 26 09:22:55 CST 2017, time=2017-02-26, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=298094, encodeId=524029809499, content=不错耶.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=2, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3b2c1627329, createdName=owlhealth, createdTime=Tue Mar 20 17:18:40 CST 2018, time=2018-03-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1929292, encodeId=c9c71929292e9, content=<a href='/topic/show?id=9e604625ab' target=_blank style='color:#2F92EE;'>#Chest#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4625, encryptionId=9e604625ab, topicName=Chest)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c48a270, createdName=Smile2680, createdTime=Fri Jul 14 16:24:00 CST 2017, time=2017-07-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2050605, encodeId=29a020506057f, content=<a href='/topic/show?id=95f8e042dd' target=_blank style='color:#2F92EE;'>#EST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7042, encryptionId=95f8e042dd, topicName=EST)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e9a6357, createdName=xiangyuzhou971, createdTime=Thu Aug 17 17:24:00 CST 2017, time=2017-08-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1957581, encodeId=1fff195e58140, content=<a href='/topic/show?id=201d5223614' target=_blank style='color:#2F92EE;'>#急性呼吸困难#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52236, encryptionId=201d5223614, topicName=急性呼吸困难)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/TnzXXl41yf6V8fHrDb5JdtxOgpaY6vplUhHtL8BzDh1xMtcap9H1IOlE8umxPGovhIuVkeGTY26eNUFCFaOheQ/132, createdBy=29702500197, createdName=ms6279672939590805, createdTime=Sun Jun 18 16:24:00 CST 2017, time=2017-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281847, encodeId=8553128184e34, content=<a href='/topic/show?id=21753963364' target=_blank style='color:#2F92EE;'>#呼吸困难#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=39633, encryptionId=21753963364, topicName=呼吸困难)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=365d170, createdName=chenwq08, createdTime=Mon Feb 27 11:24:00 CST 2017, time=2017-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1284289, encodeId=d76512842892a, content=<a href='/topic/show?id=d27a9280461' target=_blank style='color:#2F92EE;'>#超声检查#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=92804, encryptionId=d27a9280461, topicName=超声检查)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=649f191, createdName=zzc2211, createdTime=Mon Feb 27 11:24:00 CST 2017, time=2017-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=177934, encodeId=ae621e793405, content=应该没有那么可靠, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib3IzoRn621JdKCFUI4XvNELcibocrAVU6aUzEVDSaf3rYH08PUYUiagGqxAEhj8g9WqqNvD1CupIpCrmnR2OrqHZh/0, createdBy=7f181365728, createdName=飛歌, createdTime=Sun Feb 26 09:22:55 CST 2017, time=2017-02-26, status=1, ipAttribution=)]
    2017-02-26 飛歌

    应该没有那么可靠

    0

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