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山东大学学报 (医学版) ›› 2021, Vol. 59 ›› Issue (7): 50-56.doi: 10.6040/j.issn.1671-7554.0.2020.1715

• • 上一篇    

床旁肺脏超声及评分对70例新生儿呼吸窘迫综合征的诊治效果

刘晓1,郭新元2,张德健2,李琦2,李宁1,薛江2   

  • 发布日期:2021-07-16
  • 通讯作者: 薛江. E-mail: sdxj69@163.com
  • 基金资助:
    2015年医院科研基金种子基金(S2015010006)

Effects of bedside lung ultrasonography and lung ultrasonography score in the diagnosis and treatment of 70 cases of neonatal respiratory distress syndrome

LIU Xiao1, GUO Xinyuan2, ZHANG Dejian2, LI Qi2, LI Ning1, XUE Jiang2   

  1. 1. Department of Anesthesiology;
    2. Department of Neonatology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250033, Shandong, China
  • Published:2021-07-16

摘要: 目的 研究床旁肺脏超声(LUS)及其评分在诊断新生儿呼吸窘迫综合征(NRDS)及评估肺泡表面活性物质(PS)疗效中的作用。 方法 选择确诊的NRDS患儿70例为观察组,非肺病患儿70例为对照组。将患儿肺脏的体表投影分为12个区域。记录每个区域的超声下NRDS征象和LUS评分。观察组于PS治疗前行床旁LUS检查,对照组纳入研究后即行床旁LUS检查。两组对比,以评估LUS在诊断NRDS中的价值。观察组中60例符合应用PS指征,于PS应用后12 h再次行床旁LUS检查。对比PS应用前后血气分析及胸片等结果、LUS下NRDS征象的检出率及LUS评分,观察LUS在评估PS疗效中的作用。 结果 观察组NRDS征象检出率以及LUS评分均高于对照组(P<0.001)。LUS评分对NRDS诊断有较高的灵敏度(98.57%)、特异度(100%),对预测NRDS患儿使用PS亦具有较高灵敏度(90.00%)、特异度(90.00%)。观察组PS应用后12 h,较PS应用前的NRDS征象明显减少, LUS评分明显降低(P<0.001)。 结论 床旁LUS诊断NRDS准确可靠,动态观察并结合LUS评分可准确评估PS对NRDS的治疗效果。

关键词: 床旁肺脏超声, 肺超声评分, 新生儿呼吸窘迫综合征, 肺表面活性物质

Abstract: Objective To investigate the effects of bedside lung ultrasonography(LUS)and LUS scores on diagnosing neonatal respiratory distress syndrome(NRDS)and evaluating the pharmacological effects of pulmonary surfactant(PS). Methods A total of 70 neonates who were diagnosed with NRDS were allocated to the observation group, while the other 70 without lung diseases were allocated to the control group. The chest surface reflection was divided to 12 zones. NRDS signs in LUS and LUS scores were recorded. Bedside LUS was performed before PS treatment in the observation group, while LUS was performed after enrollment in the control group. The LUS results between two groups were compared to evaluate the diagnostic value of LUS in NRDS neonates. A total of 60 newborns in the observation group who need PS underwent another bedside LUS examination at 12 h after PS application. NRDS signs in LUS and LUS scores were compared before and after PS application, and the blood gas analysis and chest X-ray results were also compared. The role of LUS in the therapeutic effect of PS was also evaluated. Results The detection rate of NRDS signs in LUS and LUS score in observation group were significantly higher than those in control group(P<0.001). LUS score showed a high sensitivity(98.57%)and specificity(100%)in the diagnosis of NRDS, and it predicted the use of PS in neonates with NRDS with a high sensitivity(90.00%)and specificity(90.00%). NRDS signs in the observation group reduced significantly 12 h after PS application than before, and LUS scores also decreased(P<0.001). Conclusion Bedside LUS is accurate and reliable in diagnosis of NRDS. The effects of PS can be accurately evaluated by real-time bedside LUS and LUS scores.

Key words: Bedside lung ultrasonography, Lung ultrasonography score, Neonatal respiratory distress syndrome, Pulmonary surfactant

中图分类号: 

  • R722
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