Study On The Value Of Bedside Ultrasound In The Etiological Diagnosis Of Hypoxemia In Patients With Multiple Trauma

Objective:To explore the accuracy,specificity,sensitivity,positive and negative predictive value of bedside ultrasound in the diagnosis of various etiologies of hypoxemia in patients with multiple trauma,and identify its effect in clinical application.Method:32 patients with multiple trauma complicated with hypoxemia admitted to Emergency Intensive Care Unit(EICU)of the First Affiliated Hospital of Nanchang University were recruited from July 2018 to February 2019.The routine examinations(including medical history,physical examination and laboratory examination,etc),bedside ultrasound and chest CT examinations were used to analyze the etiologies of hypoxemia.The results of CT diagnosis were used as the "gold standard" to assess the other results.The diagnostic accuracy,sensitivity,specificity,positive predictive value and negative predictive value of routine examinations and bedside ultrasound were calculated on the basis of CT results for various etiologies of hypoxemia in patients with multiple trauma,and comparative analysis was carried out.The Kappa consistency test and the paired chi-square test(McNemar test)were used to calculate the Kappa,chi-square and P values among the three examination methods and to evaluate whether the three methods were consistent,the size of the consistency and the difference in the etiological diagnosis.And the receiver operator characteristic curve(ROC curve)was used to evaluate the diagnostic efficacy of routine examinations and bedside ultrasound for various etiologies of hypoxemia in patients with multiple trauma.Results:1.Compared with routine examinations,the diagnostic accuracy,specificity,sensitivity,positive predictive value and negative predictive value of bedside ultrasound in the diagnosis of various etiologies of hypoxemia(pneumothorax,rib fracture,pulmonary contusion,pleural effusion,lung consolidation,pulmonary edema and pericardial effusion)in patients with multiple trauma are higher.2.Bedside ultrasound and chest CT examinations were consistent with the results of various etiologies of hypoxemia in patients with multiple trauma(Kappa>0.75,P<0.001),and were superior to routine examinations.3.Bedside ultrasound has good diagnostic efficiency in the diagnosis of various etiologies of hypoxemia in patients with multiple trauma,and the diagnostic efficacy is superior to routine examinations.Conclusion:Bedside ultrasound has good consistency with chest CT examinations in the etiology diagnosis of multiple trauma patients complicated with hypoxemia,and the diagnosis results are reliable.