Vai Trò Của Siêu Âm Phổi Trong Chẩn Đoán Sớm Và Phân Loại Viêm Phổi Do Covid-19

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Tác giả: Minh Vương Trần, Thị Tố Uyên Võ

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y Dược học Phạm Ngọc Thạch, 2023

Mô tả vật lý: tr.56

Bộ sưu tập: Metadata

ID: 339143

Thêm vào giỏ Liên kết toàn văn

Virus Corona gây hội chứng hô hấp cấp tính nặng 2, viết tắt SARS-CoV-2 là tác nhân gây ra bệnh viêm đường hô hấp cấp do virus Corona 2019 (COVID-19), xuất hiện lần đầu tiên vào tháng 12 năm 2019. Sự gia tăng nhanh chóng số lượng ca nhiễm dẫn tới tình trạng quá tải bệnh nhân tại khoa Cấp cứu đang trở thành vấn đề đáng lo ngại tại nhiều quốc gia trên thế giới, trong đó có Việt Nam. Trong hoàn cảnh đó, quá trình sàng lọc đòi hỏi một quy trình tối ưu hóa trong việc xác định, phân loại bệnh nhân nhanh chóng để phục vụ hoạt động điều hướng và xử trí kịp thời. Chụp cắt lớp vi tính (Computed Tomography scan - CT scan) ngực thường được coi là phương thức hình ảnh tiêu chuẩn vàng giúp phát hiện sớm tổn thương phổi ở các bệnh nhân mắc COVID-19. Tuy nhiên, việc sử dụng CT scan ngực còn hạn chế bởi tính sẵn có, nhu cầu phải di chuyển bệnh nhân ra khỏi khu cách ly và những nguy cơ liên quan tới nhiễm xạ. Siêu âm phổi tại giường với ưu điểm không xâm lấn, có thể thực hiện nhanh chóng, được xem như biện pháp thay thế hữu ích để phân loại bệnh nhân COVID-19 có hay không có tổn thương phổi với độ nhạy và độ tin cậy cao. Kết quả đánh giá hình thái học phổi qua siêu âm tại giường giúp lựa chọn chính xác hơn liệu pháp cung cấp oxy và thông khí phù hợp cho từng bệnh nhân thông qua việc phân biệt các kiểu hình hội chứng nguy kịch hô hấp cấp (Acute Respiratory Distress Syndrome - ARDS): Kiểu L hay kiểu H, khu trú haylan tỏa. Trong bài báo này, chúng tôi đề nghị một quy trình tiếp cận viêm phổi COVID-19 sử dụng siêu âm tại giường để chẩn đoán và phân loại bước đầu bệnh nhân tại khoa cấp cứu.AbstractSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of Coronavirus Disease of 2019 (COVID-19), that first identified in December 2019. Hospital flooding of patients with COVID-19 imposes a huge burden on the medical system. This situation can be somewhat mitigated with optimization of patient identification, triage and management. Chest Computed Tomography scan (CT) is often considered the gold - standard imaging modality for early detection of lung damage in patients with COVID-19. However, the use of chest CT is limited because of its availability, the need of moving patients out of the isolation area, and the risk of radiation exposure.Bedside lung ultrasound, a useful alternative to classify COVID-19 patients with or without lung injury with high sensitivity and reliability, is noninvasive and can be performed quickly. The identification of phenotypes based on lung morphology through bedside lung ultrasound can be helpful to better target mechanical ventilation of individual patients with acute respiratory distress syndrome, distinguishing different ARDS phenotypes: Type L and type H, focal or non-focal. In this paper, we propose a COVID-19 pneumonia approach using bedside ultrasound for the initial diagnosis and triage of patients in the emergency department. DOI: 10.59715/pntjmp.1.1.8

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