摘要
目的探讨肺部超声检查在血液透析合并新型冠状病毒感染中的诊断及治疗策略,以期为临床同行提供参考依据。方法分析1例成功治愈的维持性血液透析合并重型新型冠状病毒感染患者的诊断、治疗等基本临床资料,采用“新型冠状病毒感染”“血液透析”“肺部超声检查”作为关键词对中国知网、PubMed数据库2020-2023年发表的文献进行检索。结果维持性血液透析合并新型冠状病毒感染患者经氧气治疗、抗病毒、抗炎、血液净化(利用肺部超声评估肺部B线变化)、抗感染、抗凝等治疗后痊愈出院,白细胞介素-6、淋巴细胞计数、C反应蛋白、降钙素原、红细胞沉降率、D-二聚体水平均正常,咽拭子新型冠状病毒核酸抗原检测阴性,床旁肺部超声检查提示双肺未见明显B线,肺部CT检查提示肺部渗出明显吸收。文献检索结果:共检索到文献35篇,排除16篇,最终保留可用文献19篇。结合病例分析及文献复习,对肺部超声检查在维持性血液透析合并新型冠状病毒感染中的临床诊断及治疗方法进行分析总结。结论床旁肺部超声检查在识别和分层维持性血液透析合并重型新型冠状病毒感染患者方面非常有效,可即时、准确评估患者的容量状态,保证患者透析的充分性。
Objective To explore the diagnosis and treatment strategy of lung ultrasound in hemodialysis patients with Corona Virus Disease 2019(COVID-19),in order to provide reference for clinical colleagues.Methods The basic clinical data of the diagnosis and treatment of a patient with severe COVID-19 who was successfully cured on maintenance hemodialysis were analyzed.“COVID-19,hemodialysis,lung ultrasound examination”were used as the key words to search the literature published in CNKI and PubMed database from 2020 to 2023.Results The patient on maintenance hemodialysis complicated with COVID-19 was cured and discharged after oxygen therapy,antiviral,anti-inflammatory,hemodialysis treatment(lung ultrasound was used to evaluate the changes of lung B line),anti-infection,anticoagulation and other treatments.The levels of interleukin-6,lymphocyte count,C-reactive protein,procalcitonin,erythrocyte sedimentation rate,and D-dimer were normal.The COVID-19 nucleic acid antigen test of throat swab was negative.Bedside lung ultrasound examination showed no obvious B-line in both lungs,and lung CT examination showed obvious absorption of exudation in lung.Literature search results:a total of 35 literatures were retrieved,16 literatures were excluded and 19 literatures were finally retained.Combined with case analysis and literature review,the clinical diagnosis and treatment methods of lung ultrasound in maintenance hemodialysis patients with COVID-19 were analyzed and summarized.Conclusion Bedside lung ultrasound is very effective in the identification and stratification of severe COVID-19 in maintenance hemodialysis patients.It can immediately and accurately assess the volume status of patients and ensure the adequacy of dialysis.
作者
王开振
许生甜
唐能源
李琦晖
WANG Kaizhen;XU Shengtian;TANG Nengyuan;LI Qihui(Department of Nephrology,Chongqing Hospital of Traditional Chinese Medicine,Chongqing 400013,China)
出处
《检验医学与临床》
CAS
2024年第8期1162-1165,共4页
Laboratory Medicine and Clinic
基金
重庆市科卫联合中医药科研项目(2023MSXM168)。
关键词
重型新型冠状病毒感染
维持性血液透析
肺部超声检查
诊断
治疗策略
severe Corona Virus Disease 2019
maintenance hemodialysis
lung ultrasound examination
diagnosis
treatment strategy
