摘要
目的 探讨超声评估肺不张在全麻中的应用效果.方法 选取2019年1月至2020年12月在皖南医学院第二附属医院行全麻手术患者80例作为研究对象,以胸部CT确诊围手术期发生肺不张为金标准,分为肺不张组(39例)和对照组(41例).均分别于入室后开通静脉通道(T1)、气管插管后30 min(T2)、拔管后30 min(T3)、术后24 h(T4)及术后48 h(T5)时间点行肺部超声(LUS)采集左上前胸、左下前胸、右上前胸、右下前胸、左上侧胸、左下侧胸、右上侧胸、右下侧胸、左后上区、左后下区、右后上区及右后下区等12个区域图像,并采用改良的评估肺通气的半定量评分方法对两组5个时间点LUS分值进行比较.结果 两组患者T1时不同肺分区的LUS评分差异无统计学意义(均P＞0.05);不同时间同一肺分区的LUS评分存在不同程度的差异(均P＜0.05),T2～T5时左上前胸、左下前胸、右上前胸、右下前胸、左上侧胸、右上侧胸、左后上区、右后上区LUS评分差异无统计学意义(均P＞0.05);肺不张组T2～T5左下侧胸、右下侧胸、左后下区、右后下区的LUS评分均高于对照组(均P＜0.05).结论 LUS可用于评估全麻中肺不张,具有广泛的临床应用及推广价值.
Abstract
Objective To explore the application effect of ultrasound evaluation of atelectasis in general anesthesia.Methods Eighty patients who underwent general anesthesia surgery at the Second Affiliated Hospital of Wannan Medical College from January 2019 to December 2020 were selected as the study subjects.The gold standard was chest CT diagnosis of perioperative atelectasis,and they were divided into atelectasis group(39 cases)and control group(41 cases).Twelve regional images,including left upper anterior chest,left lower anterior chest,right upper anterior chest,right lower anterior chest,left upper chest,left lower chest,right upper chest,right upper chest,right lower chest,right upper chest,right lower chest,right upper chest,right lower chest,right lower chest,right lower chest,left upper chest,right lower chest,left upper chest,right lower chest,left upper posterior region,left lower chest,left lower posterior region,left lower posterior region,right upper posterior region,and right lower posterior region,were collected by pulmonary ultrasound(LUS)at time points T,after entering the room,30 minutes after tracheal intubation(T2),30 minutes after extubation(T3),24 hours after surgery(T4),and 48 hours after surgery(T5),And an improved semi quantitative scoring method for evaluating lung ventilation was used to compare the LUS scores of the two groups at 5 time points.Results There was no statistically significant difference in LUS scores between the two groups of patients in different lung zones at T,(all P＞0.05);There are varying degrees of differences in LUS scores for the same lung partition at different times(all P＜0.05).There was no statistically significant difference in LUS scores between T2 and T5 for left upper anterior chest,left lower anterior chest,right upper anterior chest,left upper chest,right upper chest,left upper posterior region,and right upper posterior region(all P＞0.05);The LUS scores of the T2-T5 atelectasis group in the lower left chest,lower right chest,lower left posterior area,and lower right posterior area were higher than those of the control group(all P＜0.05).Conclusions LUS can be used to evaluate atelectasis during general anesthesia and has broad clinical application and promotion value.
基金项目
皖南医学院校级重点科研项目培育基金(WK2019ZF12)
NETL
NSTL
万方数据