RESUMEN
Objective:To study the clinical significance of bilateral asymmetric signs of lungs of bedside ultrasound in order to improve the diagnosis and treatment of pulmonary diseases and protocol of pulmonary ultrasound.Methods:The ultrasound imaging data of patients admitted to the department of critical care medicine of the Affiliated Hospital of Qingdao University from September 2017 to May 2019 were retrospectively analyzed. The clinical data of patients were collected, and the lung ultrasound image data and clinical diagnosis were sorted and analyzed.Results:A total of 535 critical patients ultrasound imaging data were reviewed, and 469 patients who were unable to obtain clear lung ultrasound images and lung symmetry signs were excluded. Finally, a total of 66 patients with ultrasound bilateral lung asymmetry signs during hospitalization were enrolled in the analysis. Seventeen patients (25.76%) had pneumothorax with unilateral pleural slide or lung spot, 12 (18.18%) had pneumonia with unilateral focal B line, fragment sign and tissue like sign, 21 (31.82%) had unilateral pleural effusion with unilateral liquid dark area, 8 (12.12%) had sputum obstruction with unilateral local lung consolidation and bronchial filling sign with atelectasis, and 5 (7.58%) had deep tracheal intubation. The above ultrasonic diagnoses were confirmed by chest X-ray, chest CT, fiberoptic bronchoscopy and laboratory examination. One patient with unilateral focal B-line was transferred to another hospital for treatment, and 2 patients died of sudden death due to disappearance of unilateral pleural sliding sign or unilateral pulmonary pulsation sign. The clinical diagnosis was not clear (4.54%).Conclusion:The asymmetric signs of pulmonary ultrasound clearly indicate the existence of pulmonary diseases that need to be treated in a timely manner, and the pulmonary ultrasound examination protocol of bilateral contrast is helpful for clinical diagnosis.