分析气管插管气囊上方分泌物的超声表现，探讨超声在气管插管分泌物探查中的应用价值。

选取2018年11月至2019年3月在解放军总医院呼吸科接受带气囊上方吸引装置的气管插管治疗的患者30例，在导管拔出前行床旁超声检查探查导管气囊上方有无分泌物，并记录分泌物的超声表现，然后经侧孔吸引以观察有无分泌物吸出，最后拔出气管插管时在气管镜监测下观察气道有无分泌物残留。以侧孔吸引及气管镜检查结果为"金标准"，将超声检查结果与"金标准"进行对比分析。

侧孔吸引及气管镜监测共确定有积液（分泌物）患者23例，无积液患者7例，超声检出有积液患者22例，有1例漏诊为无积液。22例患者中，超声表现为低回声17例（17/22，77.3%），无回声5例（5/22，22.7%）；此外，12例（12/22，54.5%）表现为低或无回声内混有微泡样气体回声。所有22例阳性患者的积液经探头加压均可见液体样"波动"。与"金标准"相比，超声检查评估气管插管气囊上方分泌物的敏感度、特异度、阳性预测值、阴性预测值和准确性分别为95.7%、100.0%、100.0%、87.5%、96.7%。进行双盲判读的2位超声医师的评估结果具有良好的一致性，Kappa值为0.842。

超声作为一种简便易行的床旁检查方法，在气管插管气囊上方分泌物探查中具有良好的应用价值，能够为临床评估分泌物清理时机和效果提供可靠的参考依据，从而预防呼吸机相关性肺炎的发生。

To assess the value of ultrasound in detecting the secretions above the airbag of endotracheal catheter.

Thirty patients with enhanced endotracheal intubation were examined by bedside ultrasonography to obtain sonographic images and videos to observe secretions in disposable syringes drained from the endotracheal intubation catheter. When finally removing the endotracheal catheter under bronchoscope monitoring, airway secretions were observed. The results of secretions in syringes and airway were compared with the ultrasonic results.

The results of secretions in syringes and airway confirmed a total of 23 patients with effusion and 7 patients without effusion. Among them, 22 patients with effusion were detected by ultrasonography, while another patient with effusion was misdiagnosed as having no effusion, and the remaining 7 patients were found without effusion. The secretions manifested as hypoechoic or anechoic spaces on ultrasonography, 54.5% had scattered hyperechoic like microbubble gas, and 100.0% had liquid "fluctuation sensation" as the probe exerted pressure. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ultrasound were 95.7%, 100.0%, 100.0%, 87.5%, and 96.7%, respectively, and there were no significant difference between the two methods. The consistency of observation by the two physicians was 0.842, indicating a good consistency.

Ultrasonography can detect the secretions above the airbag of endotracheal catheter, and can be used as a simple and noninvasive bedside examination for critically ill patients.