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山东大学学报 (医学版) ›› 2018, Vol. 56 ›› Issue (6): 29-34.doi: 10.6040/j.issn.1671-7554.0.2017.1239

• 临床医学 • 上一篇    下一篇

肺脏超声在新生儿感染性肺炎诊断中的临床价值

袁鹏,李娅,张飞雪,王青   

  1. 1.山东大学第二医院超声医学中心, 山东 济南 250033;2.山东大学齐鲁医院放射科, 山东 济南 250012
  • 发布日期:2022-09-27
  • 通讯作者: 王青. E-mail:wangqing663@163.com
  • 基金资助:
    山东省科技厅重点研发项目(2017GSF218100)

Clinical value of lung ultrasound in the diagnosis of neonatal infectious pneumonia

YUAN Peng, LI Ya, ZHANG Feixue, WANG Qing   

  1. 1. Ultrasonic Medical Center, The Second Hospital of Shandong University, Jinan 250033, Shandong, China;
    2. Radiology Department, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Published:2022-09-27

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摘要： 目的 探讨肺脏超声(LUS)在新生儿感染性肺炎(IPN)中的临床应用价值。 方法 回顾性分析2016年5月至2017年10月住院的80例IPN患儿的LUS及胸部X线(CXR)检查结果,比较两者的检出率,并对所有LUS诊断为IPN的患儿进行LUS随访,观察疗效。 结果 80例IPN患儿中LUS诊断76例,CXR诊断65例,其中4例CXR表现为阳性而LUS表现为阴性,15例CXR表现为阴性而LUS表现为阳性。76例患儿均行LUS随访观察,至10~14 d时40例患儿的声像图表现为正常,15例患儿表现为实变区消失,但仍可见散在或较致密的B-线;13例患儿的实变区域较入院时明显减小,表现为胸膜下的小片状实变,8例患儿的实变区较入院时变化不明显且其中4例伴有肺搏动。 结论 肺脏超声对IPN的诊断具有很高的临床价值,能动态观察病情的变化,可作为IPN的首选影像学检查诊断方法。

关键词: 肺脏超声, 新生儿, 肺炎, 胸部X线

Abstract: Objective To discuss the clinical value of lung ultrasound(LUS)in the diagnosis of neonatal infectious pneumonia(IPN). Methods The chest X-ray(CXR)and LUS results of 80 infants with IPN clinical signs and symptoms from May 2016 to Oct. 2017 were retrospectively analyzed, and the positive diagnosis rates were also comparied. The IPN infants diagnosed by LUS were followed up to observe therapeutic effects. Results The positive diagnosis rate of LUS and CXR were respective 95%(76/80)and 81%(65/80), in which 4 infants were CXR positive while LUS negative, 15 infants were CXR negative while LUS positive. Seventy-six infants were followed up with LUS, in which 40 showed a complete regression, 15 had absorptions of consolidation while with scattered or confluent B-lines, 13 had significantly reduced consolidation, 8 had no obvious changes in size of consolidation, and 4 exhibited a “lung pulse”. Conclusion LUS is of great value in diagnosis and monitor the progresses of IPN, and can be used as the preferred diagnostic method in imaging.

Key words: Lung ultrasound, Neonatal, Pneumonia, Chest X-ray

中图分类号: 

  • R445
[1] 郭艳梅,刘翠青.河北省儿童医院新生儿呼吸衰竭的临床流行病学特点[J].中华围产医学杂志,2012, 15(11): 670-675. GUO Yanmei, LIU Cuiqing. Clinical epidemiological characteristics of neonatal respiratory failure in Childrens Hospital of Hebei Province[J]. Chin J Perinat Med, 2012, 15(11): 670-675.
[2] Lichtenstein DA, Lascols N, Mezière G, et al. Ultrasound diagnosis of alveolar consolidation in the critically ill[J]. Intensive Care Med, 2004, 30(2): 276-281.
[3] Alrajhi K, Woo MY, Vaillancourt C. Test characteristics of ultrasonography for the detection of pneumothorax: a systematic review and meta-analysis[J]. Chest, 2012, 141(3): 703-708.
[4] Caiulo VA, Gargani L, Caiulo S, et al. Lung ultrasound characteristics of community-acquired pneumonia in hospitalized children[J]. Pediatr Pulmonol, 2013, 48(3): 280-287.
[5] Chen L, Zhang Z. Beside ultrasonography for diagnosis of pneumothorax[J]. Quant Imageing Med Surg, 2015, 5(4): 618-623.
[6] Reissig A, Gramegna A, Aliberti S. The role of lung ultrasound in the diagnosis and follow-up of community-acquired pneumonia[J]. Eur J Intern Med, 2012, 23(5): 391-397.
[7] Volpicelli G, Elbarbary M, Blaivas M, et al. International evidence based recommendations for point-of-care lung ultrasound[J]. Intensive Care Med, 2012, 38(4): 577-591.
[8] 肖梅,叶鸿瑁,丘小汕.实用新生儿学[M].4版.北京:人民卫生出版社,2011: 401-405.
[9] Strauss K, Kaste S. The ALARA(as low as reasonably achievable)concept in pediatric interventional and fluoroscopic imaging: striving to keep radiation doses as low as possible during fluoroscopy of pediatric patients-a white paper executive summary[J]. Pediatr Radiol, 2006, 36(2): 110-112.
[10] Frush DP. Radiation, thoracic imaging, and children: radiation safety[J]. Radiolclin North Am, 2011, 49(5): 1053-1069.
[11] Thomas KE, Parnell-Parmley JE, Haidar S, et al. Assessment of radiation dose awareness among pediatricians[J]. Pediatr Radiol, 2006, 36(8): 823-832.
[12] Reali F, Sferrazza Papa GF, Carlucci P, et al. Can lung ultrasound replace chest radiography for the diagnosis of pneumonia in hospitalized children?[J]. Respiration, 2014, 88(2): 112-115.
[13] Copetti R, Cattarossi L. Ultrasound diagnosis of pneumonia in children[J]. Radiol Med, 2008, 113(2): 190-198.
[14] Pagano A, Numis FG, Visone G, et al. Lung ultrasound for diagnosis of pneumonia in emergency department[J]. Intern Emerg Med, 2015, 10(7): 851-854.
[15] Reissig A, Copetti R, Mathis G, et al. Lung ultrasound in the diagnosis and follow-up of community acquired pneumonia: a prospective multicentre diagnostic accuracy study[J]. Chest, 2012, 142(4): 965-972.
[16] 刘敬,王华伟,韩涛,等.肺脏超声诊断新生儿感染性肺炎[J].中华围产医学杂志,2014, 17(7): 468-472. LIU Jing, WANG Huawei, HAN Tao, et al. Lung ultrasonography for the diagnosis of severe neonatal pneumonia[J]. Chinese Journal of Perinatal Medicine, 2014, 17(7): 468-472.
[17] Basile V, Di Mauro, Scalini E, et al. Lung ultrasound: a useful tool in diagnosis and management of bronchiolitis[J]. BMC Pediatr, 2015, 15(1): 63.
[18] Tsai NW, Ngai CW, Mok KL, et al. Lung ultrasound imaging in avian influenza A(H7N9)respiratory failure[J]. Crit Ultrasound J, 2014, 6(1): 1-8.
[19] 刘敬,刘颖,王华伟,等.肺脏超声对新生儿肺不张的诊断价值[J].中华儿科杂志, 2013, 51(9): 644-649. LIU Jing, LIU Ying, WANG Huawei, et al. Lung ultrasound for diagnosis of neonatal atelectasis[J]. Chin J Pediatr, 2013, 51(9): 644-649.
[20] Lichtenstein DA, Lascols N, Prin S, et al. The “lung pulse”: an early ultrasound sign of complete atelectasis[J]. Intensive Care Med, 2003, 29(12): 2187-2192.
[21] Luri D, De Candia A, Bazzocchi M. Evaluation of the lung in children with suspected pneumonia: usefulness of ultrasonography[J]. Radiol Med, 2009, 114(2): 321-330.
[22] Nazerian P, Volpicelli G, Vanni S, et al. Accuracy of lung ultrasound for the diagnosis of consolidations when compared to chest computed tomography[J]. Am J Emerg Med, 2015, 33(5): 620-625.
[23] Shah VP, Tunik MG, Tsung JW. Prospective evaluation of clinicianperformed point-of-care ultrasound for the diagnosis of pneumonia in children[J]. JAMA Pediatr, 2013, 167(2): 119-125.
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