[1]封 婷,张 皓,王克江.超声与胸部X线摄影在创伤性气胸诊断价值的Meta分析[J].医学信息,2020,33(10):70-77.[doi:10.3969/j.issn.1006-1959.2020.10.020]
 FENG Ting,ZHANG Hao,WANG Ke-jiang.Meta Analysis of the Diagnostic Value of Ultrasound and Chest X-ray Photography in Traumatic Pneumothorax[J].Medical Information,2020,33(10):70-77.[doi:10.3969/j.issn.1006-1959.2020.10.020]
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超声与胸部X线摄影在创伤性气胸诊断价值的Meta分析()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年10期
页码:
70-77
栏目:
论著
出版日期:
2020-05-15

文章信息/Info

Title:
Meta Analysis of the Diagnostic Value of Ultrasound and Chest X-ray Photography in Traumatic Pneumothorax
文章编号:
1006-1959(2020)10-0070-08
作者:
封 婷张 皓王克江
(天津市西青医院影像中心1,胸心外科2, 天津 300380)
Author(s):
FENG TingZHANG HaoWANG Ke-jiang
(Imaging Center1,Department of Thoracic Surgery2,Xiqing Hospital of Tianjin,Tianjin 300380,China)
关键词:
超声胸部X线摄影计算机断层扫描创伤性气胸Meta分析
Keywords:
UltrasoundChest X-ray photographyComputed tomographyTraumatic pneumothoraxMeta analysis
分类号:
R655
DOI:
10.3969/j.issn.1006-1959.2020.10.020
文献标志码:
A
摘要:
目的 采用Meta分析方法评估超声和胸部X线摄影对创伤性气胸的诊断价值。方法 计算机检索PubMed、Embase和Cochrane Library数据库,收集有关超声与胸部X线摄影诊断创伤性气胸的相关文献。按照纳入标准,对文献进行筛选、数据提取和质量评价。运用RevMan5.3、Meta-Disc1.4和STATA/SE15.0软件对纳入研究各统计量进行合并分析。结果 共纳入16篇文献,患者2259例。超声诊断创伤性气胸的灵敏度及95%CI为0.87(0.77~0.93),特异度及95%CI为0.99(0.98~0.99),阳性似然比及95%CI为78.9(38.0~163.5),阴性似然比及95%CI为0.13(0.07~0.24),诊断比值比及95%CI为611(193~1933),验后概率为95%,综合受试者工作特征曲线下面积及95%CI为0.99(0.98~1.00)。胸部X线摄影诊断创伤性气胸的灵敏度及95%CI为0.43(0.33~0.53),特异度及95%CI为1.00(0.99~1.00),阳性似然比及95%CI为182.0(34.9~949.4),阴性似然比及95%CI为0.57(0.48~0.68),诊断比值比及95%CI为317(60~1677),验后概率为98%,综合受试者工作特征曲线下面积及95%CI为0.89(0.86~0.92)。结论 超声与胸部X线摄影诊断创伤性气胸有着各自的诊断价值,而超声有着更高的诊断效能,但仍需纳入高质量的研究进一步分析。
Abstract:
Objective To evaluate the diagnostic value of ultrasound and chest X-ray photography for traumatic pneumothorax using Meta analysis method.Methods PubMed, Embase and Cochrane Library databases were searched by computer to collect relevant literatures on ultrasound and chest X-ray photography to diagnose traumatic pneumothorax. According to the inclusion criteria, screening, data extraction and quality evaluation of the literature. Use RevMan5.3, Meta-Disc1.4 and STATA/SE15.0 software to conduct a combined analysis of the statistics included in the study.Results A total of 16 articles were included, with 2259 patients. The sensitivity and 95%CI of ultrasound diagnosis for traumatic pneumothorax were 0.87 (0.77~0.93), specificity and 95%CI were 0.99 (0.98~0.99), positive likelihood ratio and 95%CI were 78.9 (38.0~163.5), negative likelihood ratio and 95% CI were 0.13 (0.07~0.24), diagnostic odds ratio and 95%CI were 611(193~1933), post-test probability was 95%, and the area under the comprehensive receiver operating characteristic curve and 95%CI was 0.99(0.98~1.00).The sensitivity and 95%CI of chest X-ray diagnosis of traumatic pneumothorax were 0.43 (0.33~0.53), specificity and 95%CI were 1.00 (0.99~1.00), positive likelihood ratio and 95%CI were 182.0 (34.9~949.4),the negative likelihood ratio and 95%CI were 0.57(0.48~0.68), the diagnostic odds ratio and 95%CI were 317(60~1677), the post-test probability was 98%, the area under the comprehensive receiver operating characteristic curve and 95%CI was 0.89(0.86~0.92).Conclusion Ultrasound and chest X-ray photography have their own diagnostic value for the diagnosis of traumatic pneumothorax. Ultrasound has higher diagnostic efficacy, but it still needs to be included in high-quality research for further analysis.

参考文献/References:

[1]Sauter TC,Hoess S,Lehmann B,et al.Detection of pneumothoraces in patients with multiple blunt trauma:use and limitations of eFAST[J].Emerg Med J,2017,34(9):568-572. [2]Kozaci N,Avci M,Ararat E,et al.Comparison of ultrasonography and computed tomography in the determination of traumatic thoracic injuries[J].Am J Emerg Med,2019,37(5):864-868. [3]Ianniello S,Piccolo CL,Buquicchio GL,et al.First-line diagnosis of paediatric pneumonia in emergency: lung ultrasound(LUS)in addition to chest-X-ray(CXR)and its role in follow-up[J].Br J Radiol,2016,89(1061):20150998. [4]Ekpe EE,Eyo C.Determinants of mortality in chest trauma patients[J].Niger J Surg,2014,20(1):30-34. [5]Mollberg NM,Tabachnick D,Lin FJ,et al.Age-associated impact on presentation and outcome for penetrating thoracic trauma in the adult and pediatric patient populations[J].J Trauma Acute Care Surg,2014,76(2):273-278.[6]Hefny AF,Kunhivalappil FT,Paul M,et al.Anatomical locations of air for rapid diagnosis of pneumothorax in blunt trauma patients[J].World J Emerg Surg,2019(14):44.[7]Rahimi-Movaghar V,Yousefifard M,Ghelichkhani P,et al.Application of Ultrasonography and Radiography in Detection of Hemothorax;a Systematic Review and Meta-Analysis[J].Emerg (Tehran),2016,4(3):116-126.[8]Montoya J,Stawicki SP,Evans DC,et al.From FAST to E-FAST:an overview of the evolution of ultrasound-based traumatic injury assessment[J].Eur J Trauma Emerg Surg,2016,42(2):119-126. [9]Kozaci N,Ay MO,Avci M,et al.The comparison of radiography and point-of-care ultrasonography in the diagnosis and management of metatarsal fractures[J].Injury,2017,48(2):542-547. [10]Kozaci N,Ay MO,Akcimen M,et al.The effectiveness of bedside point-of-care ultrasonography in the diagnosis and management of metacarpal fractures[J].Am J Emerg Med,2015,33(10):1468-1472. [11]Trovato G,Sperandeo M.A picture is worth a thousand words:the need for CT for assessment of size and distribution of pneumothorax[J].Intensive Care Med,2014,40(10):1614-1615. [12]Alrajab S,Youssef AM,Akkus NI,et al.Pleural ultrasonography versus chest radiography for the diagnosis of pneumothorax:review of the literature and meta-analysis[J].Crit Care,2013,17(5):R208. [13]Ebrahimi A,Yousefifard M,Mohammad Kazemi H,et al.Diagnostic Accuracy of Chest Ultrasonography versus Chest Radiography for Identification of Pneumothorax:A Systematic Review and Meta-Analysis[J].Tanaffos,2014,13(4):29-40.[14]Qu YJ,Yang ZR,Sun F,et al.[Risk on bias assessment:(6)A Revised Tool for the Quality Assessment on Diagnostic Accuracy Studies(QUADAS-2)][J].Chinese Journal of Epidemiology,2018,39(4):524-531. [15]Deeks JJ,Macaskill P,Irwig L.The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed[J].J Clin Epidemiol,2005,58(9):882-893. [16]Rowan KR,Kirkpatrick AW,Liu D,et al.Traumatic pneumothorax detection with thoracic US:correlation with chest radiography and CT--initial experience[J].Radiology,2002,225(1):210-214. [17]Kirkpatrick AW,Sirois M,Laupland KB,et al.Hand-held thoracic sonography for detecting post-traumatic pneumothoraces:the Extended Focused Assessment with Sonography for Trauma(EFAST)[J].J Trauma,2004,57(2):288-295. [18]Blaivas M,Lyon M,Duggal S.A prospective comparison of supine chest radiography and bedside ultrasound for the diagnosis of traumatic pneumothorax[J].Acad Emerg Med,2005,12(9):844-849. [19]Soldati G,Testa A,Pignataro G,et al.The ultrasonographic deep sulcus sign in traumatic pneumothorax[J].Ultrasound Med Biol,2006,32(8):1157-1163. [20]Zhang M,Liu ZH,Yang JX,et al.Rapid detection of pneumothorax by ultrasonography in patients with multiple trauma[J].Crit Care,2006,10(4):R112. [21]Soldati G,Testa A,Sher S,et al.Occult traumatic pneumothorax:diagnostic accuracy of lung ultrasonography in the emergency department[J].Chest,2008,133(1):204-211. [22]Nagarsheth K,Kurek S.Ultrasound detection of pneumothorax compared with chest X-ray and computed tomography scan[J].Am Surg,2011,77(4):480-484.[23]Nandipati KC,Allamaneni S,Kakarla R,et al.Extended focused assessment with sonography for trauma(EFAST)in the diagnosis of pneumothorax:experience at a community based level I trauma center[J].Injury,2011,42(5):511-514. [24]Hyacinthe AC,Broux C,Francony G,et al.Diagnostic accuracy of ultrasonography in the acute assessment of common thoracic lesions after trauma[J].Chest,2012,141(5):1177-1183. [25]Abbasi S,Farsi D,Hafezimoghadam P,et al.Accuracy of emergency physician-performed ultrasound in detecting traumatic pneumothorax after a 2-h training course[J].Eur J Emerg Med,2013,20(3):173-177. [26]Ojaghi Haghighi SH,Adimi I,Shams Vahdati S,et al.Ultrasonographic diagnosis of suspected hemopneumothorax in trauma patients[J].Trauma Mon,2014,19(4):e17498.[27]Kaya S,Cevik AA,Acar N,et al.A study on the evaluation of pneumothorax by imaging methods in patients presenting to the emergency department for blunt thoracic trauma[J].Ulus Travma Acil Cerrahi Derg,2015,21(5):366-372. [28]Soult MC,Weireter LJ,Britt RC,et al.Can routine trauma bay chest x-ray be bypassed with an extended focused assessment with sonography for trauma examination[J].Am Surg,2015,81(4):336-340.[29]Ziapour B,Haji HS."Anterior convergent"chest probing in rapid ultrasound transducer positioning versus formal chest ultrasonography to detect pneumothorax during the primary survey of hospital trauma patients:a diagnostic accuracy study[J].J Trauma Manag Outcomes,2015(9):9. [30]Mumtaz U,Zahur Z,Chaudhry MA,et al.Bedside Ultrasonography:AUseful Tool for Traumatic Pneumothorax[J].J Coll Physicians Surg Pak,2016,26(6):459-462. [31]Vafaei A,Hatamabadi HR,Heidary K,et al.Diagnostic Accuracy of Ultrasonography and Radiography in Initial Evaluation of Chest Trauma Patients[J].Emerg(Tehran),2016,4(1):29-33.[32]Abdulrahman Y,Musthafa S,Hakim SY,et al.Utility of extended FAST in blunt chest trauma:is it the time to be used in the ATLS algorithm[J].World J Surg,2015,39(1):172-178.[33]Deng BY,Li N,Wu WS,et al.Use of Neonatal Lung Ultrasound for the Early Detection of Pneumothorax[J].Am J Perinatol,2019.

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更新日期/Last Update: 2020-05-15