超声诊断气胸的准确性:新生儿和成人的比较——系统评价和荟萃分析。

IF 2.1 4区 医学 Q3 RESPIRATORY SYSTEM Canadian respiratory journal Pub Date : 2019-12-03 eCollection Date: 2019-01-01 DOI:10.1155/2019/5271982
Hamid Dahmarde, Fateme Parooie, Morteza Salarzaei
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引用次数: 34

摘要

目的:通过系统回顾和荟萃分析,探讨超声在新生儿和成人气胸诊断中的准确性。方法:由两位独立研究者(MS和HD)检索2009年1月1日至2019年1月1日发表的相关研究。我们在PubMed的MEDLINE、ovid的Embase™、Cochrane图书馆和Trip数据库中检索已发表的英文文献。对于以其他语言发表的文献,我们检索了国家数据库(Magiran和SID)、KoreaMed和LILACS,并检索了OpenGrey (http://www.opengrey.eu/)和世界卫生组织临床试验登记处(http://who.int/ictrp),以获取未发表的文献和正在进行的研究。搜索策略中使用的关键词是气胸或超声或胸部超声或新生儿或成人或气胸或敏感性或特异性或诊断准确性。还检索了既往研究资源和系统评价列表,以确定已发表的研究(MS和HD)。采用Meta-Disc 1.4进行分析。结果:10项研究共调查了1565例患者(255例新生儿,1212例成人,101例疑似气胸的儿科)。在成人和新生儿人群中,胸部超声诊断气胸的总体特异性为85.1%,可信区间为95% (95% CI 81.1%-88.5%)。在95%的置信区间,灵敏度为98.6% (95% CI 97.7%-99.2%)。诊断优势比为387.72 (95% CI 76.204-1972.7)。对于新生儿气胸的诊断,超声灵敏度为96.7%,可信区间为95% (95% CI 88.3% ~ 99.6%)。在95%的置信区间,特异性为100% (95% CI 97.7%-100%)。对于成人气胸的诊断,超声灵敏度为82.9%,可信区间为95% (95% CI 78.3-86.9%)。在95%的置信区间,特异性为98.2% (95% CI 97.0%-99.0%)。诊断优势比为423.13 (95% CI 45.222-3959.1)。分析研究表明,“缺肺滑动”征诊断气胸的敏感性为87.2% (95% CI 77.7 ~ 93.7),特异性为99.4% (95% CI 96.5% ~ 100%)。DOR为556.74 (95% CI 100.03-3098.7)。“肺点”征象诊断气胸的敏感性为82.1% (95% CI 71.7% ~ 89.8%),特异性为100% (95% CI 97.6% ~ 100%)。DOR为298.0 (95% CI 58.893-1507.8)。结论:超声诊断气胸准确可靠;此外,它可以导致及时诊断,特别是在新生儿气胸。使用这种方法有利于治疗过程;该成像技术的优点是无电离辐射,操作简便。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Accuracy of Ultrasound in Diagnosis of Pneumothorax: A Comparison between Neonates and Adults-A Systematic Review and Meta-Analysis.

Objective: The present systematic review and meta-analysis were conducted to investigate the accuracy of ultrasound in the diagnosis of pneumothorax in neonates and adults.

Method: The searches were conducted by two independent researchers (MS and HD) to find the relevant studies published from 01/01/2009 until the end of 01/01/2019. We searched for published literature in the English language in MEDLINE via PubMed, Embase™ via ovid, the Cochrane Library, and Trip database. For literature published in other languages, we searched national databases (Magiran and SID), KoreaMed, and LILACS, and we searched OpenGrey (http://www.opengrey.eu/) and the World Health Organization Clinical Trials Registry (http://who.int/ictrp) for unpublished literature and ongoing studies. The keywords used in the search strategy were pneumothorax or ultrasound or chest ultrasonography or neonate or adult or aerothorax or sensitivity or specificity or diagnostic accuracy. The list of previous study resources and systematic reviews was also searched for identifying the published studies (MS and HD). Analyses were performed using Meta-Disc 1.4.

Results: In total, 1,565 patients (255 neonates, 1212 adults, and 101 pediatrics suspected of pneumothorax) were investigated in 10 studies. The overall specificity of chest ultrasound in the diagnosis of pneumothorax in both populations of adults and neonates was 85.1% at the confidence interval of 95 percent (95% CI 81.1%-88.5%). At the confidence interval of 95 percent, the sensitivity was 98.6% (95% CI 97.7%-99.2%). The diagnostic odds ratio was 387.72 (95% CI 76.204-1972.7). For the diagnosis of pneumothorax in neonates, the ultrasound sensitivity was 96.7% at the confidence interval of 95 percent (95% CI 88.3%-99.6%). At the confidence interval of 95 percent, the specificity was 100% (95% CI 97.7%-100%). For the diagnosis of pneumothorax in adults, the ultrasound sensitivity was 82.9% at the confidence interval of 95 percent (95% CI 78.3-86.9%). At the confidence interval of 95 percent, the specificity was 98.2% (95% CI 97.0%-99.0%). The diagnostic odds ratio was 423.13 (95% CI 45.222-3959.1). Analyzing studies indicated that the sensitivity of "absence lung sliding" sign for the diagnosis of pneumothorax was 87.2% (95% CI 77.7-93.7), and specificity was 99.4% (95% CI 96.5%-100%). DOR was 556.74 (95% CI 100.03-3098.7). The sensitivity of "lung point" sign for the diagnosis of pneumothorax was 82.1% (95% CI 71.7%-89.8%), and the specificity was 100% (at the confidence interval of 95% CI 97.6%-100%). DOR was 298.0 (95% CI 58.893-1507.8).

Conclusion: The diagnosis of pneumothorax using ultrasound is accurate and reliable; additionally, it can result in timely diagnoses specifically in neonatal pneumothorax. Using this method facilitates the therapy process; lack of ionizing radiation and easy operation are benefits of this imaging technique.

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来源期刊
Canadian respiratory journal
Canadian respiratory journal 医学-呼吸系统
CiteScore
4.20
自引率
0.00%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Canadian Respiratory Journal is a peer-reviewed, Open Access journal that aims to provide a multidisciplinary forum for research in all areas of respiratory medicine. The journal publishes original research articles, review articles, and clinical studies related to asthma, allergy, COPD, non-invasive ventilation, therapeutic intervention, lung cancer, airway and lung infections, as well as any other respiratory diseases.
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