摘要
目的:分析重症超声快速管理方案对呼吸重症监护病房(ICU)患者急性呼吸困难或血流动力学不稳定病因诊断的作用。方法:选取铜川市人民医院急救中心2017年3月至2018年11月收治的98例急性呼吸困难或血流动力学不稳定的患者作为观察对象。在进行常规诊疗时运用重症超声快速管理方案对患者病因进行初步判断,记录相应的初步诊断时间、初始正确治疗时间、确定诊断时间、初始诊断正确率、启动其他诊断时间及其他专业会诊时间,然后分析重症超声快速管理方案的病因诊断价值。结果:重症超声快速管理方案对ICU患者急性呼吸困难或血流动力学不稳定病因总计初步诊断时间为(15.03±6.31)min,初始正确治疗时间为(34.55±14.12)min,确定诊断时间为(66.55±16.88)min,初始诊断正确率为91.84%,启动其他诊断时间为(45.67±13.11)min,其他专业会诊时间为(108.33±33.19)min。重症超声快速管理方案针对不同疾病的诊断正确率、敏感度和特异度分别为:93.33%、90.30%、94.01%(急性呼吸窘迫综合征),91.67%、93.55%、93.32%(急性肺水肿),80.00%、86.20%、94.61%(急性肺栓塞),88.89%、88.35%、96.60%(肺实变),91.67%、92.34%、93.57%(分布性休克),88.89%、90.68%、95.01%(心源性休克)。结论:重症超声快速管理方案对ICU患者急性呼吸困难或血流动力学不稳定的病因诊断正确率、敏感度、特异度较高,能节省早期病因判断及治疗方案制定、评估、选择的时间,值得临床予以推广。
Objective To analyze the effect of critical ultrasonic rapid management program on the diagnosis of the causes of acute dyspnea or hemodynamic instability in patients in respiratory intensive care unit(ICU).Methods A total of 98 patients with acute dyspnea or hemodynamic instability admitted to the emergency center of Tongchuan People′s Hospital from March 2017 to November 2018 were selected as observation objects.In the routine diagnosis and treatment,the critical ultrasonic rapid management program was used to make a preliminary judgment on the cause of the patients.The corresponding initial diagnosis time,initial correct treatment time,confirmed diagnosis time,correct rate of initial diagnosis,time for starting other diagnoses and time for other professional consultations were recorded.The value of critical ultrasonic rapid management program in etiological diagnosis was analyzed.Results By critical ultrasonic rapid management program,the total initial diagnosis time of acute dyspnea or hemodynamic instability in ICU patients was(15.03±6.31)min,the initial correct treatment time was(34.55±14.12)min,and the confirmed diagnosis time was(66.55±16.88)min,the correct rate of initial diagnosis was 91.84%,the time for starting other diagnoses was(45.67±13.11)min,and the time for other professional consultations was(108.33±33.19)min.The diagnostic accuracy,sensitivity and specificity of the critical ultrasonic rapid management program were 93.33%,90.30%,94.01%(acute respiratory distress syndrome),91.67%,93.55%,93.32%(acute pulmonary edema),80.00%,86.20%,94.61%(acute pulmonary embolism),88.89%,88.35%,96.60%(pulmonary consolidation),91.67%,92.34%,93.57%(distributed shock),88.89%,90.68%,95.01%(cardiogenic shock).Conclusions Critical ultrasonic rapid management program is more accurate,sensitive and specific for the etiological diagnosis of acute dyspnea or hemodynamic instability in ICU patients.It can save the time of early etiology judgment and treatment planning,evaluation and selection,which is worthy of clini
作者
强军涛
和建武
Qiang Juntao;He Jianwu(Department of Intensive Care,Tongchuan People′s Hospital,Tongchuan 727000,China)
出处
《国际呼吸杂志》
2020年第15期1154-1159,共6页
International Journal of Respiration
关键词
急性呼吸困难
血流动力学不稳定
重症超声快速管理方案
病因诊断
Acute dyspnea
Hemodynamic instability
Critical ultrasonic rapid management program
Etiological diagnosis
