THIẾT LẬP BẢNG ĐIỂM DỰA VÀO SIÊU ÂM ĐỂ TIÊN ĐOÁN SỐT XUẤT HUYẾT DENGUE CÓ SỐC Ở TRẺ EM

Abstract

Background: Ultrasound is a simple tool for detecting peritoneal and pleural fluid in patient with Dengue fever (DF). Objective: to establish a ultrasound scoring system for predicting of developing shock in patients with DF. Methods: a retrospective study of 446 dengue patients with ultrasound, between 1 and14 years old, from the medical records stored at An Giang Hospital. Using multivariate logistic regression model to identify the variables capable of predicting shock. Results: A total of 446 patients (154 with shock and 292 without shock) were examined by ultrasound in the pre-shock phase. The incidence of fluid collections in 6 positions (Morison’s pouch, Pouch of Douglas’ cul-de-sac, subcapsular space, abdominal free fluid, right and left pleural fluid) and gallbladder wall thickening (GBWT) in DF patients with shock was higher than in DF patients without shock. The ultrasound scoring system for predicting shock was as follows:

Regions

Points

GBWT ³ 5mm

No

0

Yes

1

Morison’s pouch

No

0

Yes

1

Subcapsular space

No

0

Yes

3

Douglas’ cul-de-sac

No

0

Yes

2

Floating bowel loops

No

0

Yes

3

Right pleural effusion

No

0

Yes

1

Left pleural effusion

No

0

Yes

1

Ultrasound score is

sum of all points

 (0-12)

At the cut-off > 5 points, the value of predicting shock in DF patients had sensitivity of 79.8% and specificity of 82.7%.Conclusion: Sonography provides a fast, portable, and noninvasive method for detecting fluid collections in peritoneal and pleural cavities. The use of ultrasound scoring system is of value for predicting of developing shock.