关键词: 床旁即时超声；肺超声；心力衰竭；Meta分析

Abstract: Objective: To systematically evaluate nurses' ability to accurately identify ultrasound B-lines and pleural effusion using Point-of-Care Ultrasonography (POCUS) in screening cardiogenic dyspnea, and clarify the required intensity of standardized training, so as to provide evidence-based basis for emergency and critical care ultrasound nursing training and the application of monitoring technologies. Methods: Chinese and English databases were comprehensively searched to recruit diagnostic accuracy trials which evaluated the use of ultrasound B-lines or pleural effusion by nurses to screen cardiac dyspnea from their inception to March 31, 2025. Two reviewers independently screened the articles, extracted data and evaluated the risk of bias of the included studies. Meta-analysis was performed using Meta Disc 1.4. Results: A total of eight studies were identified with 847 patients. All nurses received structured ultrasound training, with a focus on developing the ability to identify B-lines and pleural effusion. After training, the pooled sensitivity, the pooled specificity, the pooled positive likelihood ratio, the pooled negative likelihood ratio, the pooled Area Under the Summary Receiver Operating Characteristic Curve (AUC), the pooled Kappa value, the pooled ICC value of nurse-performed POCUS to identify B-lines in screening cardiogenic dyspnea were 0.94 [95% CI (0.90, 0.97)], 0.84 [95% CI (0.79, 0.88)], 7.34 [95% CI (2.12, 25.44)], 0.08 [95% CI (0.03, 0.19)], 0.968 (SE=0.019), 0.79 [95% CI (0.70, 0.85)], and 0.87 [95% CI (0.82, 0.91)]. For the nurse-performed POCUS to identify pleural effusion in screening cardiogenic dyspnea, the sensitivity ranged from 0.88 to 0.98, the specificity ranged from 0.73 to 1.00, and the coefficient of agreement ranged from 0.66 to 0.96. Conclusion: Nurses can accurately acquire and interpret lung ultrasound images after training, demonstrating good diagnostic efficacy for cardiogenic dyspnea and having the potential for clinical application and promotion.

Key words: Point-of-Care Ultrasonography; lung ultrasound; heart failure; Meta-analysis