肺超声在新生儿呼吸功能障碍疾病中的临床应用价值研究  

Clinical application value of lung ultrasound in neonatal respiratory dysfunction

作　　者：罗燕 曾洁[1] 张卫权[1] 彭娟[2] 牛锦东[2] 梁琨[1] LUO Yan;ZENG Jie;ZHANG Wei-quan;PENG Juan;NIU Jin-dong;LIANG Kun(Department of Pediatrics,the First Affiliated Hospial of Kunming Medical University,Kunming,Yunnan 650032,China;Department of Ultrasound,the First Affiliated Hospial of Kunming Medical University,Kunming,Yunnan 650032,China)

机构地区：[1]昆明医科大学第一附属医院儿科,云南昆明650032 [2]昆明医科大学第一附属医院超声科,云南昆明650032

出　　处：《中国儿童保健杂志》2020年第11期1239-1241,1245,共4页Chinese Journal of Child Health Care

基　　金：2016年云南省医疗卫生单位内设研究机构科研项目(2016NS061)。

摘　　要：目的分析肺超声与胸部X线对新生儿呼吸功能障碍疾病(NRD)诊断的准确率,以及肺超声评分与呼吸评分的相关性,为肺超声在NRD中的临床应用提供依据。方法选取2018年8月-2019年1月由昆明医科大学第一附属医院产科转入儿科新生儿重症监护病房(NICU)的NRD患儿60例(呼吸功能障碍组),以及同期院内转入无呼吸功能障碍的新生儿30例(无呼吸功能障碍组)为研究对象。进行肺超声检查、肺超声评分,呼吸功能障碍组同时行胸部X线检查,并收集相关临床资料,行SA评分及Downes评分。所有资料通过SPSS 23.0统计软件进行数据分析。结果肺超声诊断的灵敏度和特异度均为96.7%,准确率为88.3%;X线诊断的准确率为83.3%,两种诊断方法呈中等强度一致(Kappa=0.523,P<0.001)。肺超声评分与SA评分和Downes评分均呈正相关(rs=0.585、0.533,P<0.001)。结论肺超声与胸部X线对NRD诊断具有较好的一致性;肺超声在NRD中具有重要的临床应用价值。Objective To analyze the diagnostic accuracy rate of lung ultrasound and chest X-ray in neonatal respiratory dysfunction(NRD),as well as the consistency between lung ultrasound score and respiratory score,so as to provide evidence for clinical application of lung ultrasound in NRD.Methods A total of 60 neonates with NRD in NICU of the First Affiliated Hospital of Kunming Medical University were enrolled in this study from August 2018 to January 2019(respiratory dysfunction group),and 30 neonates without respiratory disorder were selected as non-respiratory dysfunction group.All subjects performed lung ultrasound,and pulmonary ultrasound scores.The NRD group underwent chest X-ray examination and received Silverman-Anderson(SA)score and Downes score assesment.All data were analyzed by SPSS 23.0.Results The sensitivity and specificity of the lung ultrasound diagnosis for NRD were 96.7%,the accuracy of lung ultrasound diagnosis was 88.3%,and the accuracy of chest X-ray diagnosis was 83.3%.The two diagnostic methods were moderately consistent(Kappa=0.523,P<0.001).Lung ultrasound score was positively correlated with SA score and Downes score(r_s=0.585,0.533,P<0.001).Conclusions Lung ultrasound and chest X-ray have a good consistency in the diagnosis of NRD.Lung ultrasound has important clinical application value in NRD.

关 键 词：肺超声 新生儿 呼吸功能障碍 肺 

分 类 号：R722.1[医药卫生—儿科] R455.1[医药卫生—临床医学]