床旁CR胸片与床旁超声检查对新生儿肺透明膜病的临床诊断价值  

The Value of Clinical Diagnosis of Neonatal Hyaline Membrane Disease Between Bedside CR Chest Film and Bedside Ultrasound

作　　者：梁赞浩 郁成 LIANG Zanhao;YU Cheng(Zhanjiang Maternal and Child Health Hospital, Zhanjiang 524000, China)

机构地区：[1]湛江市妇幼保健院,广东湛江524000 [2]广东医科大学附属医院,广东湛江524000

出　　处：《现代医院》2019年第9期1380-1382,共3页Modern Hospitals

摘　　要：目的观察及比较床旁CR胸片与床旁超声检查对新生儿肺透明膜病(HMD)的临床诊断效果。方法纳入自2017年1月-2019年3月湛江市妇幼保健院与广东医科大学附属医院拟诊为HMD的125例患儿,患儿全部经过床旁CR胸片与超声检查,结合影像学、临床症状等检查作为确诊依据,分析CR胸片及超声检查的敏感性、特异性、阳性预测值、阴性预测值。结果本组患儿最终明确诊断102例,其中Ⅰ级20例,占比19. 61%;Ⅱ级43例,占比42. 16%;Ⅲ级30例,占比29. 41%;Ⅳ级9例,占比8. 82%。床旁超声敏感性为80. 39%、特异性为48. 00%、阳性预测值86. 32%、阴性预测值为37. 50%。床旁CR胸片敏感性为91. 18%、特异性为68. 00%、阳性预测值为92. 08%、阴性预测值为65. 00%。床旁CR胸片的敏感性高于床旁胸部超声,差异具有统计学意义(X^2=4. 860,P <0. 05)。床旁CR胸片的阴性预测值也高于床旁胸部超声,差异具有统计学意义(X^2=4. 461,P <0. 05)。结论床旁CR胸片检查操作便捷、准确率高,能够为HMD临床诊断提供有效的参考。Objective To observe and compare the clinical diagnostic effect of bedside CR chest film and bedside ultrasound in neonatal hyaline membrane disease( HMD). Methods 125 cases of HMD from January 2017 to March 2019 from Zhanjiang City Maternal and Child Health Care were included in this study. All the patients underwent bedside CR chest radiography and ultrasonography. The sensitivity,specificity,positive predictive value and negative predictive value of CR chest radiography and ultrasonography were analyzed based on imaging and clinical symptoms. Results In this group,102 patients were diagnosed clearly,including 20 cases of grade Ⅰ,accounting for 19. 61%;43 cases of grade Ⅱ,accounting for42. 16%;30 cases of grade Ⅲ,accounting for 29. 41%;9 cases of grade Ⅳ,accounting for 8. 82%. Bedside ultrasound sensitivity was 80. 39%,specificity was 48. 00%,positive predictive value was 86. 32%,and negative predictive value was37. 50%. Bedside CR chest radiograph sensitivity was 91. 18%,specificity was 68. 00%,positive predictive value was92. 08%,and negative predictive value was 65. 00%. The sensitivity of the bedside CR chest radiograph was higher than that of the bedside chest ultrasound,and the difference was statistically significant( X^2= 4. 860,P < 0. 05). The negative predictive value of bedside CR chest radiograph was also higher than bedside chest ultrasound,and the difference was statistically significant( X^2= 4. 461,P < 0. 05). Conclusion Bedside CR chest X-ray examination is convenient and accurate,which can provide an effective reference for clinical diagnosis of HMD.

关 键 词：床旁CR胸片 床旁超声检查 新生儿肺透明膜病 临床诊断 

分 类 号：R722.12[医药卫生—儿科] R445[医药卫生—临床医学]