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感染性心內膜炎繼發腸系膜上動脈假性動脈瘤破裂一例

床旁肺部超聲評估對心臟術后早期肺實變和肺不張的診斷準確性研究Accuracy of bedside lung ultrasonography in diagnosis of pulmonary consolidation and atelectasis in postoperative cardiac surgery patients

目的 探討床旁肺部超聲對心臟術后早期肺實變和肺不張的診斷準確性。 方法 選取 2014 年 9 月至 2015 年 8 月四川大學華西醫院心臟大血管外科行心臟大血管手術（包括冠狀動脈旁路移植術、瓣膜置換術等）后 1 周之內出現呼吸衰竭的 49 例患者，其中男 24 例、女 25 例，年齡（54.4±13.2）歲。收集患者術后床旁肺部超聲及胸部 CT 檢查結果，進行對照、分析、總結。 結果 在肺實變和肺不張的診斷中，胸部 CT 診斷 47 例（95.9%）患者為陽性，肺部超聲評估方案（BLUE方案）診斷 45 例（91.8%）患者為陽性，床旁肺部超聲與胸部 CT 診斷一致率為 95.9%。 結論 床旁肺部超聲可作為篩查肺實變和肺不張的方法。

Correlation between lung ultrasound score and postoperative pulmonary complications after cardiac surgery

ObjectiveTo investigate the correlation between lung ultrasonography and pulmonary complications after cardiac surgery.MethodsFifty-two patients after cardiac surgery in our hospital from January to May 2017 were recruited. There were 27 males and 25 females, aged 60.50±10.43 years. Lung ultrasonography was performed by specially trained observers, video data were saved, and lung ultrasound score (LUS) were recorded. The correlation between the LUS and the patients' pulmonary function was evaluated.ResultsLUS was 17.80±3.87, which was negatively correlated to the ratio of arterial PO2 to the inspired oxygen fraction (PaO2/FiO2) during examination, without significant difference (r=–0.363, P=0.095), but significantly negatively correlated to PaO2/FiO2 changes 24 hours postoperatively (r=–0.464, P=0.034).ConclusionThe changes of lung ventilation area may occur earlier than the changes of lung function. Bedside LUS is an effective method for clinical monitoring of pulmonary complications.