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首页> 外文期刊>Journal of Clinical Ultrasound: JCU >Should bedside sonography be used first to diagnose pneumothorax secondary to blunt trauma?
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Should bedside sonography be used first to diagnose pneumothorax secondary to blunt trauma?

机译：是否应该首先使用床旁超声检查来诊断继发于钝性创伤的气胸？

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Background.: Our purpose was to evaluate the effectiveness of bedside sonography (US) in the detection of pneumothorax secondary to blunt thoracic trauma. Methods.: In this prospective study, 240 hemithoraces of 120 consecutive patients with multiple trauma were evaluated with chest radiographs (CXR) and bedside thoracic US for the diagnosis of pneumothorax. CT examinations were performed in 68 patients. Fifty-two patients who did not undergo CT examinations were excluded from the study. US examinations were performed independently at bedside by two radiologists who were not informed about CXR and CT findings. CXRs were interpreted by two radiologists who were unaware of the US and CT results. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CXR and US were calculated. Results.: One hundred thirty-six hemithoraces were assessed in 68 patients. A total of 35 pneumothoraces were detected in 33 patients. On US, the diagnosis of pneumothorax was correct in 32 hemithoraces. In 98 hemithoraces without pneumothorax, US was normal. With US examination, there were three false-positive and three false-negative results. The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of US were 91.4%, 97%, 91.4%, 97%, and 97%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CXR were 82.7%, 89.7%, 68.5%, 95%, and 89.5%, respectively. Conclusions.: Bedside thoracic US is an accurate method that can be used in trauma patients instead of CXR for the detection of pneumothorax.
机译：背景：我们的目的是评估床旁超声检查在检测钝性胸外伤继发性气胸中的有效性。方法：在这项前瞻性研究中，连续120例多发伤患者的240个半月体被胸部X光片（CXR）和床旁胸部US评估，以诊断气胸。 68例患者进行了CT检查。 52名未接受CT检查的患者被排除在研究之外。美国的检查是由两名放射科医生在床旁独立进行的，他们没有获悉CXR和CT的发现。两名放射科医生对CXR进行了解释，他们并不了解美国和CT的结果。计算CXR和US的敏感性，特异性，阳性预测值，阴性预测值和准确性。结果：在68例患者中评估了一百三十六种半球形。在33例患者中共检出35例气胸。在美国，有32例半住所对气胸的诊断是正确的。在98例没有气胸的半盲犬中，US正常。在美国检查中，有3个假阳性和3个假阴性结果。 US的敏感性，特异性，阳性预测值，阴性预测值和整体准确性分别为91.4％，97％，91.4％，97％和97％。 CXR的敏感性，特异性，阳性预测值，阴性预测值和准确性分别为82.7％，89.7％，68.5％，95％和89.5％。结论：床旁胸腔超声是一种准确的方法，可用于创伤患者而不是CXR来检测气胸。

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