| 摘要: |
| 目的 比较心脏超声微泡造影和快速灌注湍流造影2种技术判断中心静脉导管尖端位置的临床诊断价值。方法 选择2020年7月至2022年3月于北京大学人民医院重症医学科行中心静脉置管的107例成人危重症患者，分别应用心脏超声微泡造影技术和快速灌注湍流造影技术判断中心静脉导管尖端的位置，并以床旁胸部X线片所示结果为标准，分析2种超声造影技术判断导管尖端位置的效果。结果 应用心脏超声微泡造影技术和快速灌注湍流造影技术判断中心静脉导管尖端位置所需时间分别为6（5～7）min和5（4～6）min ，均短于胸部X线片判断导管尖端位置所需时间［70（57～90）min］（P均<0.01）。以床旁胸部X线片作为判断导管位置的金标准，应用心脏超声微泡造影和快速灌注湍流造影2种技术判断导管尖端位置的灵敏度均高达100.0%，特异度均为81.2%。结论 相较于床旁胸部X线片，心脏超声微泡造影技术和快速灌注湍流造影技术均可快速、准确地判断中心静脉导管的位置，尤其心脏超声快速灌注湍流造影技术无须注射造影剂更值得临床推广应用。 |
| 关键词: 超声心动描记术 危重症 中心静脉置管 超声造影检查 |
| DOI：10.16781/j.CN31-2187/R.20220616 |
| 投稿时间：2022-07-22修订日期：2022-11-14 |
| 基金项目:北京大学人民医院研究与发展基金（RYD2019-43）；北京大学临床医学+X青年专项，中央高校基本科研业务费（PKU2022LCXQ031）. |
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| Clinical value of 2 cardiac contrast-enhanced ultrasound techniques in determining the position of central venous catheter tip |
| SHEN Peng1,ZHAO Lian-ze2,Lü Jie1,ZHAO Hui-ying1,AN You-zhong1* |
(1. Department of Critical Care Medicine, Peking University People's Hospital, Beijing 100044, China;
2. Department of Trauma Emergency, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
*Corresponding author) |
| Abstract: |
| Objective To compare the clinical diagnostic value of 2 different cardiac contrast-enhanced ultrasound (CEUS) techniques (ultrasonic microbubble angiography and rapid turbulence angiography) in determining the position of the central venous catheter tip. Methods A total of 107 adult critical patients with central venous catheterization who were admitted to Department of Critical Care Medicine, Peking University People's Hospital from Jul. 2020 to Mar. 2022 were enrolled. The position of the central venous catheter tip was determined by ultrasonic microbubble angiography and rapid turbulence angiography. The accuracy of the 2 CEUS techniques in determining the position of the central venous catheter tip was analyzed using the results of bedside chest X-ray (CXR) as the standard. Results The median time required to determine the position of the central venous catheter tip by ultrasonic microbubble angiography and rapid turbulence angiography was 6 (5-7) min and 5 (4-6) min, respectively, which were shorter than that by bedside CXR (70[57-90] min) (both P<0.01). With bedside CXR as the gold standard for the determination of catheter position, the ultrasonic microbubble angiography and rapid turbulence angiography showed consistent results, with a sensitivity of 100.0% and a specificity of 81.2% for both methods. Conclusion Compared with bedside CXR, the ultrasonic microbubble angiography and rapid turbulence angiography can determine the position of the central venous catheter quickly and accurately. In addition, rapid turbulence angiography without injection of contrast agent is more worthy of further clinical application. |
| Key words: echocardiography critical illness central venous catheterization contrast-enhanced ultrasonography |
