床旁心脏超声结合肺部超声在重症患者中的应用： 一项全国多中心观察性研究

张宏民; 张丽娜; 刘丽霞; 朱英; 尹万红; 何伟; 尚秀玲; 晁彦公; 吕立文; 王小亭; 刘大为; 重症超声研究组

doi:10.24920/003874

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床旁心脏超声结合肺部超声在重症患者中的应用：一项全国多中心观察性研究

中国医学科学杂志（英文版） 2021年36卷第4期页码：257-264

Original Articles | Updated：2024-04-10

- 床旁心脏超声结合肺部超声在重症患者中的应用：一项全国多中心观察性研究
- Affiliations：
  
  1. 1Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  2. 2Department of Critical Care Medicine, Xiangya Hospital, Central South University, Changsha 410013, China
  3. 3Department of Critical Care Medicine, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China
  4. 4Department of Critical Care Medicine, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou 310006, China
  5. 5Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
  6. 6Department of Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
  7. 7Department of Critical Care Medicine, Fujian Provincial Hospital, Fuzhou 350001, China
  8. 8Department of Critical Care Medicine, The First Hospital of Tsinghua University, Beijing 100016, China
  9. 9Department of Emergency Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, China
- Author bio：
  
  *E-mail: syzzyx2015@sina.com
- Funds：
- DOI：10.24920/003874
  中图分类号：
- 收稿日期：2021-01-08，
  
  网络出版日期：2021-10-09，
  
  纸质出版日期：2021-12-31
- Accepted：
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张宏民, 张丽娜, 刘丽霞, 等. 床旁心脏超声结合肺部超声在重症患者中的应用：一项全国多中心观察性研究[J]. 中国医学科学杂志（英文版）, 2021,36(4):257-264.

Zhang Hongmin, Zhang Lina, Liu Lixia, et al. Effect of Focused Cardiac Ultrasound in Combination with Lung Ultrasound on Critically Ill Patients: A Multicenter Observational Study in China[J]. Chinese medical sciences journal, 2021, 36(4): 257-264.
张宏民, 张丽娜, 刘丽霞, 等. 床旁心脏超声结合肺部超声在重症患者中的应用：一项全国多中心观察性研究[J]. 中国医学科学杂志（英文版）, 2021,36(4):257-264. DOI： 10.24920/003874.

Zhang Hongmin, Zhang Lina, Liu Lixia, et al. Effect of Focused Cardiac Ultrasound in Combination with Lung Ultrasound on Critically Ill Patients: A Multicenter Observational Study in China[J]. Chinese medical sciences journal, 2021, 36(4): 257-264. DOI： 10.24920/003874.

摘要

目的

床旁心脏超声和肺部超声在重症患者中的应用日益广泛。本研究旨在调查心脏超声联合肺部超声在重症患者中的作用

以及超声检查时机与治疗改变是否有关。

方法

本研究为多中心横断面观察性研究。连续收入重症医学科住院患者

在24 h内行床旁心脏超声和肺部超声检查

操作者根据患者的临床情况和超声检查结果做出是否需要改变治疗的判断。

结果

在收入的992例患者中

502例患者（早期组）在入科6 h内完成超声检查

490例患者（后期组）在入科6 h后完成超声检查。早期组和后期组治疗改变的比例接近（48.8%比49.0%

=0.003

=0.956）。多元分析表明

因呼吸衰竭入院是治疗改变的独立影响因素（

=2.357

95%置信区间：1.284-4.326

=0.006）;超声检查时机不是治疗改变的影响因素（

=0.725

95%置信区间：0.407-1.291

=0.275）。

结论

床旁心脏超声结合肺部超声检查能显著改变重症患者的治疗

而且24h内早期检查和后期检查均有作用。超声检查更容易给呼吸衰竭患者带来治疗改变。

Abstract

Objective

Focused cardiac ultrasound (FCU) and lung ultrasound (LU) are increasingly being used in critically ill patients. This study aimed to investigate the effect of FCU in combination with LU on these patients and to determine if the timing of ultrasound examination was associated with treatment change.

Methods

This is a multicenter cross-sectional observational study. Consecutive patients admitted to the intensive care unit (ICU) were screened for enrollment. FCU and LU were performed within the first 24 h

and treatment change was proposed by the performer based on the ultrasound results and other clinical conditions.

Results

Among the 992 patients included

502 were examined within 6 h of ICU admission (early phase group)

and 490 were examined after 6 h of admission (later phase group). The early phase group and the later phase group had similar proportions of treatment change (48.8%

. 49.0%

=0.003

=0.956). In the multivariable analysis

admission for respiratory failure was an independent variable associated with treatment change

with an odds ratio (

) of 2.357 [95% confidence interval (

): 1.284-4.326

=0.006]; the timing of examination was not associated with treatment change (

=0.725

95%

: 0.407-1.291

=0.275).

Conclusions

FCU in combination with LU

whether performed during the early phase or later phase

had a significant impact on the treatment of critically ill patients. Patients with respiratory failure were more likely to experience treatment change after the ultrasound examination.

关键词

Keywords

references

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