床旁肺部超声在儿童重度社区获得性肺炎中的应用价值  

Value of bedside lung ultrasound in the diagnosis of severe community-acquired pneumonia in children

作　　者：刘玲 王团结[2] 李树军[2] 郭喜霞[1] 徐亚利 付素珍[1] Liu Ling;Wang Tuanjie;Li Shujun;Guo Xixia;Xu Yali;Fu Suzhen(Third Pediatric Ward,First Affiliated Hospital of Xinxiang Medical University,Xinxiang,Henan 453100,China;PICU,First Affiliated Hospital of Xinxiang Medical University,Xinxiang,Henan 453100,China)

机构地区：[1]新乡医学院第一附属医院儿科三病区,河南新乡453100 [2]新乡医学院第一附属医院儿科重症监护病房,河南新乡453100

出　　处：《现代临床医学》2020年第3期191-194,共4页Journal of Modern Clinical Medicine

摘　　要：目的:探讨床旁肺部超声在儿童重度社区获得性肺炎(CAP)中的应用价值。方法:收集2016年12月至2018年8月在本院儿童重症监护病房住院并临床诊断为儿童重度CAP的患儿120例,这些患儿均在入院24 h内进行床旁肺部超声及床旁胸片检查。分析儿童重度CAP的床旁肺部超声特点,并与胸片进行比较。结果:儿童重度CAP的床旁肺部超声的特点是A线消失、B线增多、瀑布征、肺实变、支气管充气征、胸腔积液,床旁肺部超声诊断儿童重度CAP的敏感性为99%,特异性为100%,阳性预测值为100%,阴性预测值为50%,阳性似然比∞,阴性似然比为9%,约登指数0.99。结论:床旁肺部超声诊断儿童重度CAP准确可靠,敏感性高、特异性强,具有能随时检测、无辐射等优点,可作为一项儿童重度CAP的辅助诊断工具。Objective:To study the value of bedside lung ultrasound in the diagnosis of severe community-acquired pneumonia in children.Methods:From December 2016 to August 2018,120 children were collected who were hospitalized in the Pediatric Intensive Care Unit(PICU)of the first affiliated Hospital of Xinxiang Medical University and clinically diagnosed as severe community-acquired pneumonia.The children were examined by bedside lung ultrasound and bedside chest radiography within 24 hours after admission.Collect personal data,laboratory tests,chest and lung ultrasound findings.The characteristics of bedside lung ultrasound in children with severe community-acquired pneumonia were analyzed and compared with chest radiographs.Results:Characteristics of bedside lung ultrasound in children with severe community-acquired pneumonia:A-lines off,multiple Blines,waterfall sign,lung consolidation,air bronchograms and pleural effusion Receiver operating characteristic curve analysis results for bedside lung ultrasound were 95.5%sensitivity,100%specificity,100%positive predictive value,50%negative predictive value,∞positive likelihood ratio,9%negative likelihood ratio and 0.99 Yoden index.Conclusion:Bedside Lung Ultrasound is an auxiliary diagnostic tool for the diagnosis of severe community-acquired pneumonia in children,which is accurate,reliable,sensitive and specific,and has the advantages of simplicity,detection at any time and no radiation.

关 键 词：床旁肺部超声 社区获得性肺炎 重度 儿童 

分 类 号：R445.1[医药卫生—影像医学与核医学] R816.92[医药卫生—诊断学]