超声测量重症患者股四头肌的信度分析的临床研究

发布时间：2018-06-18 04:54

  本文选题：超声 + 重症　； 参考：《安徽医科大学》2017年硕士论文

【摘要】：目的超声评价股四头肌功能变化是新兴的诊断ICU获得性肌无力的方法,本研究目的是分析床旁超声在重症患者股四头肌数据测量中的信度,评估其对ICU获得性肌无力的临床诊断价值。方法研究对象为2015年10月到2016年3月入住重症医学中心时间≥4天的重症患者29例,超声医生及经过专科化超声培训的医生在相同一段时间内分别用床旁超声诊断仪重复记录患者双侧下肢股直肌(RF)横截面面积、股直肌横截面厚度以及股中间肌(VI)横截面厚度的数据,并于3天后再次测量,根据组内相关系数计算相关信度价值。结果患者入院3日后肌肉较前的出现明显的萎缩,且股直肌和股中间肌之间下降程度不同,股直肌横截面面积平均下降至89%(89%~92%),股直肌横截面厚度平均下降至98%(93%~104%),股中间肌横截面厚度平均下降至91%。同一测量者在患者入院时和3天后重复测量下肢股直肌横截面面积、股直肌横截面厚度及股中间肌横截面厚度的信度为好至优秀(ICC=0.84~0.99),且差异没有统计学意义;不同测试者间在患者入院时和三天后重复测量下肢股直肌横截面面积、股直肌横截面厚度及股中间肌厚度的信度为优秀(ICC=0.93~0.99),不同测试者分别在入院时测量左侧股中间肌横截面厚度、3天后测量右侧股直肌横截面面积以及左侧股直肌横截面厚度差异有统计学意义。结论ICU相关性肌力下降在ICU患者中普遍存在。肌肉超声在观察高质量的肌肉解剖信息方面拥有快速、无创、可重复性、简单等优点。应用超声测量下肢股直肌横截面面积及其厚度、股中间肌厚度的信度良好。其对于进一步诊断ICU相关性肌无力具有高度指导性意义
[Abstract]:Objective to evaluate the functional changes of quadriceps femoris by ultrasound is a new method for the diagnosis of acquired myasthenia in ICU. The purpose of this study was to analyze the reliability of bedside ultrasound in the measurement of quadriceps femoris muscle data in severe patients. To evaluate the clinical diagnostic value of acquired myasthenia in ICU. Methods from October 2015 to March 2016, 29 patients who were admitted to the critical Medical Center for more than 4 days were enrolled in the study. The cross-sectional area of the rectus femoris muscle of the bilateral lower extremity was recorded repeatedly by the ultrasound doctor and the doctor trained by specialist ultrasound for the same period of time, respectively, using the bedside ultrasound diagnostic instrument to record the cross section area of the rectus femoris muscle of the patients. The data of rectus femoris cross section thickness and Vi cross section thickness of medius femoris muscle were measured again 3 days later and the correlation reliability value was calculated according to the correlation coefficient within the group. Results after 3 years of admission, the muscles of the patients showed obvious atrophy, and the degree of decrease between the rectus femoris and the medius femoris was different. The average cross-sectional area of rectus femoris decreased to 89. The thickness of transverse section of rectus femoris decreased to 98 / 93104 and the thickness of medial femoral muscle decreased to 91cm on average. The cross section area of rectus femoris muscle of lower extremity was measured repeatedly on admission and 3 days later. The reliability of cross sectional thickness of rectus femoris muscle and medial femoral muscle was good to excellent ICCU 0.84 ~ 0.99, and the difference was not statistically significant. The rectus femoris cross-sectional area of the lower extremity was measured repeatedly between the different subjects on admission and three days later. The reliability of transverse sectional thickness of rectus femoris and medius femoris was 0.990.99. The cross sectional area of right rectus femoris and the cross-sectional area of left rectus femoris were measured 3 days after admission. The difference of surface thickness was statistically significant. Conclusion the decrease of muscle strength associated with ICU is common in ICU patients. Muscle ultrasound has the advantages of fast, non-invasive, reproducible and simple in observing high-quality anatomical information of muscle. The cross section area and thickness of lower limb rectus femoris muscle were measured by ultrasound, and the reliability of the thickness of medius femoris muscle was good. It is highly instructive for the further diagnosis of ICU associated myasthenia.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R459.7
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本文编号：2034186