Diagnostic value of bedside ultrasound on severe pneumonia in elderly cases and their ultrasonic characteristics / 中华老年医学杂志

ABSTRACT

Objective To evaluate the diagnostic value of bedside lung ultrasound on severe pneumonia in elderly patients.Methods Bedside lung ultrasound lung ultrasound and chest CT were performed in 104 elderly patients admitted to the emergency department for suspected severe pneumonia,from November 2010 to January 2013.According to the characteristics of the chest CT image,patients were divided into consolidation group (big leaf or lung segment distribution density shadow) and the unconsolidation group (for the performance of the cable sample,ground glass sample,or small patch sample changes).Differences in ultrasonic characteristics were compared between the two groups.Results Ultrasonic image characteristics were pulmonary consolidation,subpleural lesion,pleural changes and parapneumonic effusions in patients with severe pneumonia.Among 65 patients with chest CT image of pulmonary consolidation in consolidation group,60 patients were found pulmonary consolidation by lung ultrasound,and all 39 patients in unconsolidation group were not found pulmonary consolidation by lung ultrasound,and there was a significant difference in detect rate by lung ultrasound between the two groups (x2 =87.546,P＜ 0.001).The number of subpleural lesion and pleural changes were (1.16 ± 1.07) and (3.14 ± 2.20) respectively in consolidation group and (3.85 ± 1.93) and (11.73 ± 3.69) respectively in unconsolidation group,which had significant differences between the two groups (t=7.439,12.133,both P＜0.001).There was no significant difference in the incidence of parapneumonic effusions between the two groups (45/65 vs.29/39,x2 =0.086,P=0.496).Conclusions Ultrasound image characteristics of severe pneumonia in elderly patients included pulmonary consolidation,pleural lesions,pleural changes and parapneumonic effusions.Ultrasonic characteristics will be pleural lesions,pleural changes in severe pneumonia patients without chest CT image of pulmonary consolidation.