目的对重症超声快速管理方案在ICU重症患者急性呼吸困难或血流动力学不稳定病因诊断中的作用进行观察与探讨。方法对2012年12月至2014年12月在重庆市黔江中心医院接受治疗的100例呼吸困难或血流动力学不稳定的ICU重症患者进行临床相关研究，分析实施重症超声快速管理方案对患者病因诊断的作用。结果 ICU重症患者呼吸困难或血流动力学不稳定的病因主要有急性肺水肿（19例）、分布性休克（16例）、急性呼吸窘迫综合征（15例）、肺炎（肺实变，12例）、急性肺栓塞（10例）、心源性休克（10例），重症超声快速管理方案对上述病因的诊断正确率分别为89.47%、93.75%、93.33%、91.67%、88.89%、90.00%，敏感性分别为93.56%、92.35%、90.31%、88.36%、90.21%、91.69%，特异性分别为93.33%、93.58%、94.02%、98.61%、98.62%、95.02%。结论重症超声快速管理方案可对ICU重症患者急性呼吸困难或血流动力学不稳定病因进行较快的诊断，且具有较高的诊断正确率、敏感性、特异性。%Objective To observe and explore the effect of the Critical Ultrasonic Rapid Management Program on the e tiological diagnosis of acute dyspnea or hemodynamic instability in ICU severe patients. Methods A total of 100 ICU severe patients with acute dyspnea or hemodynamic instability in Qianjiang Central Hospital from December 2012 to December 2014 were performed the clinical related research for analyzing the effect of implementing the Critical Ultrasonic Rapid Management Program on the etiological diagnosis of acute dyspnea or hemodynamic instability. Results The main causes of acute dyspnea or hemodynamic instability in ICU severe patients were acute pulmonary edema(19 cases),distributive shock(16 cases),acute res-piratory distress syndrome (15 cases),pneumonia (lung consolidation,12 cases),acute pulmonary embolism (10 cases) and car diogenic shock(10 cases). The diagnostic accuracy rates of the Critical Ultrasonic Rapid Management Program for above etiologies were 89.47%,93.75%,93.33%,91.67%,88.89% and 90.00% respectively,the sensitivities were 93.56%,92.35%,90.31%, 88.36%,90.21% and 91.69% respectively,the specificities were 93.33%,93.58%,94.02%,98.61%,98.62% and 95.02% re-spectively. Conclusion The Critical Ultrasonic Rapid Management Program can rapidly diagnose the causes of acute dyspnea or hemodynamic instability in ICU severe patients,moreover has higher diagnostic accuracy, sensitivity and specificity.
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