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感染性心内膜炎继发肠系膜上动脉假性动脉瘤破裂一例

床旁肺部超声评估对心脏术后早期肺实变和肺不张的诊断准确性研究Accuracy of bedside lung ultrasonography in diagnosis of pulmonary consolidation and atelectasis in postoperative cardiac surgery patients

目的 探讨床旁肺部超声对心脏术后早期肺实变和肺不张的诊断准确性。 方法 选取 2014 年 9 月至 2015 年 8 月四川大学华西医院心脏大血管外科行心脏大血管手术（包括冠状动脉旁路移植术、瓣膜置换术等）后 1 周之内出现呼吸衰竭的 49 例患者，其中男 24 例、女 25 例，年龄（54.4±13.2）岁。收集患者术后床旁肺部超声及胸部 CT 检查结果，进行对照、分析、总结。 结果 在肺实变和肺不张的诊断中，胸部 CT 诊断 47 例（95.9%）患者为阳性，肺部超声评估方案（BLUE方案）诊断 45 例（91.8%）患者为阳性，床旁肺部超声与胸部 CT 诊断一致率为 95.9%。 结论 床旁肺部超声可作为筛查肺实变和肺不张的方法。

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.