超声胸膜间排液位置排除气胸,并与前后胸片上低程度的排液缩短相关。

IF 3.4 Q2 Medicine
Michal Maly, Masego Candy Mokotedi, Eva Svobodova, Marek Flaksa, Michal Otahal, Zdenek Stach, Jan Rulisek, Tomas Brozek, Michal Porizka, Martin Balik
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引用次数: 3

摘要

背景:床边显像方法定位胸腔引流液在气胸诊断中的作用尚未有前瞻性研究探讨。方法:对新冠肺炎ARDS合并气胸患者行安全三角引流后的胸部超声(CUS)和前后x线(CR)前瞻性监测。胸腔引流指数(CDI =从CR取的胸腔内CD长度/ CD刻度上的插入深度+ 5cm)的降低可估计胸腔内CD缩短。结果:本组106例气胸患者中,80例在CUS上有完全肺扩张,69例(86%)被CUS定位,CDI为0.99(0.88-1.06)。引流后残余气胸26例(24.5%),CD位于CUS处占31%,CDI为0.76 (0.6 ~ 0.93),p 50°),发生气胸的风险比无统计学意义(p结论:引流后CUS处无CD, CR处CDI低,持续漏气与残余隐匿性气胸有显著相关性,可回避前后位CR的诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Interpleural location of chest drain on ultrasound excludes pneumothorax and associates with a low degree of chest drain foreshortening on the antero-posterior chest X-ray.

Interpleural location of chest drain on ultrasound excludes pneumothorax and associates with a low degree of chest drain foreshortening on the antero-posterior chest X-ray.

Interpleural location of chest drain on ultrasound excludes pneumothorax and associates with a low degree of chest drain foreshortening on the antero-posterior chest X-ray.

Interpleural location of chest drain on ultrasound excludes pneumothorax and associates with a low degree of chest drain foreshortening on the antero-posterior chest X-ray.

Background: The role of chest drain (CD) location by bedside imaging methods in the diagnosis of pneumothorax has not been explored in a prospective study yet.

Methods: Covid-19 ARDS patients with pneumothorax were prospectively monitored with chest ultrasound (CUS) and antero-posterior X-ray (CR) performed after drainage in the safe triangle. CD foreshortening was estimated as a decrease of chest drain index (CDI = length of CD in chest taken from CR/depth of insertion on CD scale + 5 cm). The angle of inclination of the CD was measured between the horizontal line and the CD at the point where it enters pleural space on CR.

Results: Of the total 106 pneumothorax cases 80 patients had full lung expansion on CUS, the CD was located by CUS in 69 (86%), the CDI was 0.99 (0.88-1.06). 26 cases had a residual pneumothorax after drainage (24.5%), the CD was located by CUS in 31%, the CDI was 0.76 (0.6-0.93),p < 0.01. The risk ratio for a pneumothorax in a patient with not visible CD between the pleural layers on CUS and an associated low CDI on CR was 5.97, p˂0.0001. For the patients with a steep angle of inclination (> 50°) of the CD, the risk ratio for pneumothorax was not significant (p < 0.17). A continued air leak from the CD after drainage is related to the risk for a residual pneumothorax (RR 2.27, p = 0.003).

Conclusion: Absence of a CD on CUS post drainage, low CDI on CR and continuous air leak significantly associate with residual occult pneumothorax which may evade diagnosis on an antero-posterior CR.

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来源期刊
Ultrasound Journal
Ultrasound Journal Health Professions-Radiological and Ultrasound Technology
CiteScore
6.80
自引率
2.90%
发文量
45
审稿时长
22 weeks
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