本文選題：超聲 + 重癥��； 參考：《安徽醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的超聲評價股四頭肌功能變化是新興的診斷ICU獲得性肌無力的方法,本研究目的是分析床旁超聲在重癥患者股四頭肌數(shù)據(jù)測量中的信度,評估其對ICU獲得性肌無力的臨床診斷價值。方法研究對象為2015年10月到2016年3月入住重癥醫(yī)學(xué)中心時間≥4天的重癥患者29例,超聲醫(yī)生及經(jīng)過�？苹暸嘤�(xùn)的醫(yī)生在相同一段時間內(nèi)分別用床旁超聲診斷儀重復(fù)記錄患者雙側(cè)下肢股直肌(RF)橫截面面積、股直肌橫截面厚度以及股中間肌(VI)橫截面厚度的數(shù)據(jù),并于3天后再次測量,根據(jù)組內(nèi)相關(guān)系數(shù)計算相關(guān)信度價值。結(jié)果患者入院3日后肌肉較前的出現(xiàn)明顯的萎縮,且股直肌和股中間肌之間下降程度不同,股直肌橫截面面積平均下降至89%(89%~92%),股直肌橫截面厚度平均下降至98%(93%~104%),股中間肌橫截面厚度平均下降至91%。同一測量者在患者入院時和3天后重復(fù)測量下肢股直肌橫截面面積、股直肌橫截面厚度及股中間肌橫截面厚度的信度為好至優(yōu)秀(ICC=0.84~0.99),且差異沒有統(tǒng)計學(xué)意義;不同測試者間在患者入院時和三天后重復(fù)測量下肢股直肌橫截面面積、股直肌橫截面厚度及股中間肌厚度的信度為優(yōu)秀(ICC=0.93~0.99),不同測試者分別在入院時測量左側(cè)股中間肌橫截面厚度、3天后測量右側(cè)股直肌橫截面面積以及左側(cè)股直肌橫截面厚度差異有統(tǒng)計學(xué)意義。結(jié)論ICU相關(guān)性肌力下降在ICU患者中普遍存在。肌肉超聲在觀察高質(zhì)量的肌肉解剖信息方面擁有快速、無創(chuàng)、可重復(fù)性、簡單等優(yōu)點。應(yīng)用超聲測量下肢股直肌橫截面面積及其厚度、股中間肌厚度的信度良好。其對于進一步診斷ICU相關(guān)性肌無力具有高度指導(dǎo)性意義
[Abstract]:Objective to evaluate the functional changes of quadriceps femoris by ultrasound is a new method for the diagnosis of acquired myasthenia in ICU. The purpose of this study was to analyze the reliability of bedside ultrasound in the measurement of quadriceps femoris muscle data in severe patients. To evaluate the clinical diagnostic value of acquired myasthenia in ICU. Methods from October 2015 to March 2016, 29 patients who were admitted to the critical Medical Center for more than 4 days were enrolled in the study. The cross-sectional area of the rectus femoris muscle of the bilateral lower extremity was recorded repeatedly by the ultrasound doctor and the doctor trained by specialist ultrasound for the same period of time, respectively, using the bedside ultrasound diagnostic instrument to record the cross section area of the rectus femoris muscle of the patients. The data of rectus femoris cross section thickness and Vi cross section thickness of medius femoris muscle were measured again 3 days later and the correlation reliability value was calculated according to the correlation coefficient within the group. Results after 3 years of admission, the muscles of the patients showed obvious atrophy, and the degree of decrease between the rectus femoris and the medius femoris was different. The average cross-sectional area of rectus femoris decreased to 89. The thickness of transverse section of rectus femoris decreased to 98 / 93104 and the thickness of medial femoral muscle decreased to 91cm on average. The cross section area of rectus femoris muscle of lower extremity was measured repeatedly on admission and 3 days later. The reliability of cross sectional thickness of rectus femoris muscle and medial femoral muscle was good to excellent ICCU 0.84 ~ 0.99, and the difference was not statistically significant. The rectus femoris cross-sectional area of the lower extremity was measured repeatedly between the different subjects on admission and three days later. The reliability of transverse sectional thickness of rectus femoris and medius femoris was 0.990.99. The cross sectional area of right rectus femoris and the cross-sectional area of left rectus femoris were measured 3 days after admission. The difference of surface thickness was statistically significant. Conclusion the decrease of muscle strength associated with ICU is common in ICU patients. Muscle ultrasound has the advantages of fast, non-invasive, reproducible and simple in observing high-quality anatomical information of muscle. The cross section area and thickness of lower limb rectus femoris muscle were measured by ultrasound, and the reliability of the thickness of medius femoris muscle was good. It is highly instructive for the further diagnosis of ICU associated myasthenia.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R459.7
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本文編號：2034186