床旁肺部超声在新生儿肺透明膜病中的诊断价值  

Diagnostic Value of Bedside Lung Ultrasound in Neonatal Pulmonary Hyaline Membrane Disease

作　　者：宁浩杰[1] 韦德湛[1] 罗慧 谢肖云 程超[1] 成宇璐[1] 刘卫东[1] 陈洁莹[1] 吴丽园 NING Hao-jie;WEI De-zhan;LUO Hu;et al(Women and Children's Hospital Of Foshan,Foshan Guangdong,528000)

机构地区：[1]佛山市妇幼保健院B超室,广东佛山528000

出　　处：《医学临床研究》2019年第12期2355-2357,共3页Journal of Clinical Research

基　　金：广东省佛山市科技创新项目(编号:2018AB000211)。

摘　　要：【目的】探讨床旁肺部超声在新生儿肺透明膜病(HMD)中的诊断价值。【方法】选取2017年5月至2018年12月在本院诊治的新生儿HMD 90例,按照随机数表法分为床旁计算机X线摄影检查组(CR组)和床旁肺部超声检查组(US组),每组45例。以新生儿数字化成像(DR)检查作为金标准,对比两种检查方法在HMD中的诊断效能,分析床旁肺部超声在病情严重程度中的评估价值。【结果】US组诊断HMD的灵敏度、阳性预测值与CR组比较差异无统计学意义(P>0.05),特异度、阴性预测值显著高于CR组,其差异有统计学意义(P<0.05);重度HMD患儿肺超声总评分显著高于轻度患儿,PaO2/FiO2显著低于轻度患儿,其差异均有统计学意义(P<0.05)。Pearson相关分析显示:肺部超声评估HMD病情程度与PaO2/FiO2存在负相关(r=-1.655,P<0.05)。【结论】床旁肺部超声在新生儿HMD诊断中具有无创、可重复的优势,且具有较高的诊断效能,且反映病情严重程度,值得临床推广应用。【Objective】To explore the diagnostic value of bedside lung ultrasound in neonatal pulmonary hyaline membrane disease(HMD).【Methods】A total of 90 neonatal patients with lung hyaline membrane disease admitted to our hospital from May 2017 to December 2018 were selected as research objects.They were divided into the control group and the observation group by random number table method,with 45 cases in each group.The control group was given bedside computer radiography(CR)for HMD diagnosis,while the observation group was given bedside lung ultrasound(US).Taking the neonatal digital imaging(DR)examination as the gold diagnostic standard,the HMD diagnostic methods of CR and US were compared.Furthermore,bedside lung ultrasound was evaluated to assess the severity of the disease.【Results】There were no significant differences in the sensitivity and positive predictive value between the observation group(US)and the control group(CR)(P>0.05),while the specificity and negative predictive value of US were significantly higher than those of CR(P<0.05).The total pulmonary ultrasound score of severe HMD children was significantly higher than that of mild HMD children,however,PaO2/FiO2 of the severe group was significantly lower than that of the mild group.The differences were statistically significant(P<0.05).Pearson correlation analysis results showed that there was a negative correlation between pulmonary ultrasound assessment of HMD and PaO2/FiO2(r=-1.655,P<0.05).【Conclusion】Bedside lung ultrasound has the advantages of non-invasive and repeatable in the diagnosis of neonatal pulmonary hyaline membrane disease.Its high diagnostic efficiency also reflects the severity of the disease which is worthy of clinical promotion.

关 键 词：透明膜病/诊断 婴儿 新生 超声检查 多普勒 彩色 

分 类 号：R725.63[医药卫生—儿科]