协和医学杂志

2020, v.11(05) 514-517

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肺部超声与CT对新型冠状病毒肺炎肺损伤的评估:优与劣
Lung Ultrasound and CT Assessment of Lung Injury in COVID- 19: Which One is Better

李莉;张丽娜;中国重症超声研究组;
LI Li;ZHANG Li-na;Chinese Critical Ultrasound Study Group;Department of Critical Care Medicine,Xiangya Hospital,Central South University,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital);

摘要(Abstract):

肺部CT是新型冠状病毒肺炎(以下简称"新冠肺炎")暴发初期最主要的筛查手段和分级诊疗依据,是肺部损伤影像学诊断的金标准。随新冠肺炎病情进展,患者肺部CT呈现不同的病变范围与类型。肺部超声与CT相一致,随病程发展呈特征性表现。与肺部CT相比,肺部超声检查具有床旁便捷、无创等优点,减少了院内传染和转运风险,且其有助于快速鉴别呼吸衰竭的病因,实现连续动态监测,指导呼吸机参数设置、肺复张、俯卧位治疗等,在急危重症新冠肺炎的救治过程中发挥无可替代的作用。另一方面,肺部超声在探测远离胸膜病变、辨别过度通气、操作者依赖方面亦有其局限性。本文对肺部超声与CT的优劣势进行梳理,临床医师在实践过程中应取长补短,以促进新冠肺炎患者的精准诊治。
Computerized tomography(CT) is the gold standard of imaging technique for lung injury. During the early outbreak of COVID-19 in Wuhan, China, lung CT played an important role in screening and classification. With the development of COVID-19, patients' lung CT presents different lesion types and ranges. Correspondingly, Lung ultrasonography can help to quickly screen for the potential causes of respiratory failure in COVID-19 patients, which takes advantages of convenience, high-accuracy, non-radiation, and fewer transmission in hospital. Moreover, lung ultrasonography is useful for continuous and dynamic management of COVID-19. It dynamically monitors the disease progression; evaluates the effectiveness of the prone position ventilation; and guides ventilation settings, weaning, and extracorporeal membrane therapy. However, lung ultrasonography has limitations on identifying over-inflation, operator dependence, and so on. Clinicians should take advantages of lung CT and ultrasonography and make each modality complementary to the other for promoting precise strategic treatment of COVID-19 patients.

关键词(KeyWords): 新型冠状病毒肺炎;超声;CT;急性肺损伤
COVID-19;ultrasonography;computerized tomography;acute lung injury

Abstract:

Keywords:

基金项目(Foundation): 北京重症超声协会重症超声专项基金(202001)

作者(Author): 李莉;张丽娜;中国重症超声研究组;
LI Li;ZHANG Li-na;Chinese Critical Ultrasound Study Group;Department of Critical Care Medicine,Xiangya Hospital,Central South University,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital);

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