肺脏超声在肺表面活性物质治疗早产儿呼吸窘迫综合征中的评价作用

doi:10.6040/j.issn.1671-7554.0.2017.696

摘要/Abstract

摘要： 目的应用肺脏超声评估呼吸窘迫综合征(RDS)早产儿接受外源性肺表面活性物质(PS)治疗后20~24 h时肺脏声像图的改变。方法选择2016年10月至2017年5月在我院新生儿监护室住院并经临床、动脉血气分析和胸部X线检查确诊为RDS的35例早产儿为研究对象。将患儿每侧肺脏分为前、侧、后3个区域,探头与肋骨垂直对双侧肺脏的6个区域进行扫查,并将每个区域的声像图根据新的肺脏超声分型进行记录。肺脏超声检查分别于PS应用前及PS应用后20~24 h进行。X线检查于超声检查后进行。结果应用PS后,35例(100%)患儿均至少有1个肺脏区域的超声表现较前好转,其中1~2个肺脏区域的超声表现好转的患儿3例,3个或3个以上肺脏区域超声表现好转的患儿32例。PS应用后,胸部X线表现较前好转的患儿30例(86%),胸部X线表现无变化的患儿5例。结论肺脏超声能够较早地评估RDS早产儿应用PS后肺脏的超声影像改变,该技术比传统胸部X线更简单、无创。

关键词: 呼吸窘迫综合征, 肺脏超声, 肺表面活性物质, 早产儿

Abstract: Objective To evaluate the effects of pulmonary surfactant(PS)replacement therapy by using lung ultrasound in preterm infants with respiratory distress syndrome(RDS). Methods A total of 35 preterm infants diagnosed as RDS by clinical and radiographic signs in the Neonatal Intensive Care Unit(NICU)were enrolled into the study from Oct. 2016 to May 2017. Lung ultrasound was performed before and after surfactant replacement therapy within the first 20 hours to 24 hours by the same experienced ultrasonorgaphy physician. The transthoracic approach was performed with longitudinal scans of anterior, lateral and posterior chest walls. Ultrasound findings of each lung field were recorded and typed using the new system. A conventional chest X ray was performed immediately after lung ultrasound was finished. Results All the 35 patients(100%)showed an improvement of lung ultrasound findings observed in one lung field at least within 20 hours to 24 hours after surfactant administration. Three patients showed an improvement of lung ultrasound findings in one or two lung fields, and 32 patients showed an improvement in three or more than three lung areas. After surfactant administration, 30 patients(86%)showed an improvement of chest X ray,and 5 patients showed no improvement. Conclusion Lung ultrasound may enable an early detection of the effect of pulmonary surfactant replacement therapy in preterm RDS infants with the advantages of high sensitivity, non-ionizing and easy-operating.

Key words: Respiratory distress syndrome, Lung ultrasound, Pulmonary surfactant, Preterm infant

中图分类号:

R445

李娅,袁鹏,张飞雪,邵广瑞. 肺脏超声在肺表面活性物质治疗早产儿呼吸窘迫综合征中的评价作用[J]. 山东大学学报 (医学版), 2018, 56(2): 34-40.

LI Ya, YUAN Peng, ZHANG Feixue, SHAO Guangrui. Lung ultrasound for evaluating the effect of pulmonary surfactant replacement therapy in preterm infants with respiratory distress syndrome[J]. Journal of Shandong University (Health Sciences), 2018, 56(2): 34-40.

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