老年脑出血患者医院获得性重症肺炎的床旁超声影像特点及预后分析

发布时间：2018-04-13 17:37

本文选题：脑出血 + 重症肺炎　；参考：《中华医院感染学杂志》2017年22期

【摘要】：目的分析老年脑出血患者医院获得性重症肺炎的床旁超声影像特点,分析其对预后的影响。方法选取2015年1月-2016年12月医院收治的脑出血并发肺炎的患者178例,根据重症肺炎诊断标准,其中94例患者为重症肺炎,84例患者为普通肺炎,对所有患者进行床旁超声检查,观察影像学特点,综合分析患者的超声评分结果及临床资料,评估床旁超声影像结果对临床预后的影响。结果重症肺炎患者发生肺实变61例,实变率64.9%,普通肺炎患者肺实变7例,实变率8.3%,两组差异有统计学意义(P0.05);重症肺炎患者胸膜下病变数为(4.86±2.63)个,高于普通肺炎患者的(2.09±1.14)个,差异有统计学意义(P0.05);重症肺炎患者发生胸膜改变的肋间个数为(8.22±2.31)个,高于普通肺炎患者的(2.54±1.08)个,差异有统计学意义(P0.05);重症肺炎肺超声评分为(21.28±5.49)分,低于普通肺炎患者的(30.83±5.83)分,差异有统计学意义(P0.05);死亡患者肺实变率100%,胸膜下病变数(5.34±2.35)个,胸膜改变肋间个数(9.26±2.51)个,肺超声评分为(14.36±2.46)分。结论老年脑出血患者医院获得性重症肺炎的床旁超声影像特点为肺实变、胸膜下病变数多、胸膜改变肋间数多、肺超声评分低,当床旁超声结果为肺实变、胸膜下病变数超过5个、胸膜改变肋间个数超过9个、肺超声评分低于15分时,往往提示预后不佳,需要临床医师高度关注。
[Abstract]:Objective to analyze the characteristics of bedside ultrasonography in elderly patients with nosocomial severe pneumonia and its influence on prognosis.Methods 178 cases of intracerebral hemorrhage complicated with pneumonia were selected from January 2015 to December 2016. According to the diagnostic criteria of severe pneumonia, 94 cases were diagnosed as severe pneumonia and 84 cases were common pneumonia. All the patients were examined by bedside ultrasound.The imaging features were observed and the clinical data were analyzed comprehensively. The influence of bedside ultrasound findings on the clinical prognosis was evaluated.Results there were 61 patients with severe pneumonia with a consolidation rate of 64.9 and 7 patients with common pneumonia with a consolidation rate of 8.3.The difference between the two groups was statistically significant (P 0.05), and the number of subpleural lesions in severe pneumonia patients was 4.86 卤2.63, which was higher than that in common pneumonia patients (2.09 卤1.14).The number of intercostal changes in patients with severe pneumonia was 8.22 卤2.31, which was higher than that in patients with common pneumonia (2.54 卤1.08), the difference was statistically significant (P0.05), and the ultrasonic score of severe pneumonia was 21.28 卤5.49, which was lower than that of patients with common pneumonia (30.83 卤5.83).The number of subpleural lesions was 5.34 卤2.35, the number of intercostal changes of pleura was 9.26 卤2.51, and the score of pulmonary ultrasound was 14.36 卤2.46. The difference was statistically significant (P < 0.05), the rate of pulmonary consolidation was 100 and the number of subpleural lesions was 5.34 卤2.35, and the number of intercostal changes of pleura was 9.26 卤2.51.Conclusion the characteristics of bedside ultrasonography in elderly patients with nosocomial severe pneumonia are pulmonary consolidation, more subpleural lesions, more intercostal pleural changes, and lower pulmonary ultrasound scores.When the number of subpleural lesions was more than 5, the number of intercostal pleural changes was more than 9, and the ultrasonic score of lung was less than 15, the prognosis was not good, and the clinicians should pay close attention to it.
【作者单位】：海南医学院第二附属医院超声医学科;
【基金】：海南省卫生厅科研基金资助项目(琼卫2012LX-12)
【分类号】：R445.1;R563.1;R743.34

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