Primena ultrazvuka pluća u diferencijalnoj dijagnozi uzroka dispneje

  • Kristina Bulatović University of Priština/Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia
  • Andjelka Ristic - Andjelkov Military Medical Academy, Clinic for Emergency and Internal Medicine, Belgrade, Serbia
  • Vladan Perić University of Priština/Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia
  • Jovana Todorović University of Belgrade, Faculty of Medicine, Institute of Social Medicine, Belgrade, Serbia
  • Milena Pandrc Military Medical Academy, Clinic for Emergency and Internal Medicine, Belgrade, Serbia
  • Gabrijela Gojka Military Medical Academy, Clinic for Cardiology, Belgrade, Serbia
  • Danijela Vraneš Military Medical Academy, Clinic for Emergency and Internal Medicine, Belgrade, Serbia
  • Maja Šipić University of Priština/Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia
  • Dragiša Rašić University of Priština/Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia
  • Aleksandra Milenković University of Priština/Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia
  • Jelena Aritonović Pribaković University of Priština/Kosovska Mitrovica, Faculty of Medicine, Kosovska Mitrovica, Serbia
  • Milica Perić University of Belgrade, Faculty of Medicine, Institute of Social Medicine, Belgrade, Serbia
DOI: https://doi.org/10.2298/VSP230905053B
Ključne reči: dijagnoza, diferencijalna, dispneja, srce, insuficijencija, pluća, edem, ultrasonografija

Sažetak


Uvod/Cilj. Polje primene ultrazvuka (UZ) kod pregleda pluća se brzo razvija i pruža medicinskoj zajednici mnogobrojne nove dijagnostičke mogućnosti. Cilj rada bio je da se na osnovu UZ pregleda srca i pluća ispita etiologija dispneje pri prijemu bolesnika i proceni stepen slabosti srca (SS). Metode. Studijom preseka obuhvaćeno je ukupno 110 bolesnika lečenih zbog dispneje. Obuhvaćeni su svi bolesnici lečeni zbog bilo koje srčane ili plućne bolesti, kao i bolesnici koji su prijavili prvu epizodu dispneje bez bilo kakvog prethodnog oboljenja. Najvažniji dijagnostički znak na nalazu UZ pluća kod bolesnika sa SS bila je pojava B linija ili „kometa” (artefakti koji podsećaju na repove kometa), koje ukazuju na nakupljanje tečnosti u intersticijumu pluća. Rezultati. Srednji broj registrovanih „kometa” kod ukupnog broja bolesnika bio je 14,2 ± 7,4 (minimum 2, maksimum 30). Srednji broj „kometa” kod bolesnika sa SS bio je 18,8 ± 5,9. Srednji broj „kometa” kod bolesnika bez SS bio je 8,0 ± 3,7 (p ˂ 0,001). Multivarijantna linearna regresiona analiza pokazala je povezanost između broja „kometa” i postojanja SS (p ˂ 0,001). Zaključak. S obzirom na to da je procena prisustva „kometa” tokom UZ pregleda pluća bezbedna i neinvazivna, lako se može integrisati u svakodnevnu kliničku praksu, jer je pokazano da je broj plućnih „kometa” bio značajno veći kod bolesnika sa SS u odnosu na bolesnike kod kojih je dispneja bila druge etiologije.

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Objavljeno
2023/12/29
Broj časopisa
Vol. 80 Br. 12 (2023): Vojnosanitetski pregled
Rubrika
Originalni članak