肺部超声动态评估肺表面活性物质治疗早产儿呼吸窘迫综合征的临床价值  

Clinical value of lung ultrasound in the dynamic assessment of pulmonary surfactant in the treatment of preterm neonates with respiratory distress syndrome

作　　者：强光峰 赵静[1] 孟兰兰 牛峰海[1] 任雪云[1] QIANG Guangfeng;ZHAO Jing;MENG Lanlan;NIU Fenghai;REN Xueyun(Department of Pediatrics,Affiliated Hospital of Ji’ning Medical University,Shandong 272000,China)

机构地区：[1]济宁医学院附属医院儿科,山东省济宁市272000

出　　处：《临床超声医学杂志》2020年第11期856-858,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨肺部超声动态评估肺表面活性物质(PS)治疗早产儿呼吸窘迫综合征(RDS)的临床价值。方法前瞻性选取我院产科转至新生儿重症监护病房的30例RDS早产儿,分别于PS使用前及PS使用后6 h、12 h、18 h、24 h进行肺部超声检查并评分,观察PS使用前后不同时间肺部超声表现及其评分的变化规律。结果PS使用前,16例(53.3%)患儿肺部超声表现为弥漫白肺,14例(46.7%)表现为肺泡间质综合征,11例(36.7%)表现为胸膜下肺实变;PS使用后6 h,3例(10.0%)表现为弥漫白肺,2例(6.7%)可见胸膜下肺实变,均较PS使用前明显好转,差异均有统计学意义(χ^2=11.09、6.29,P=0.001、0.012)。在PS使用后12 h、18 h、24 h,所有患儿肺部超声均未见弥漫白肺、肺实变,与PS使用前比较,差异有统计学意义(χ^2=19.18,P<0.001),与PS使用后6 h比较差异无统计学意义(χ^2=1.40,P=0.24)。PS使用后6 h、12 h、18 h、24 h超声评分分别为(19.3±4.0)分、(17.4±3.9)分、(17.6±4.0)分、(17.9±4.2)分,较PS使用前(22.3±2.6)分降低,差异均有统计学意义(均P<0.05),而PS使用后6 h、12 h、18 h、24 h超声评分两两比较差异均无统计学意义。结论肺部超声可以动态评估PS对RDS的治疗效果,PS使用后6 h肺部超声即可发现肺部病变较使用前明显好转。ObjectiveTo investigate application value of lung ultrasound in the dynamic assessment of pulmonary surfactant(PS)in the treatment of preterm neonates with respiratory distress syndrome(RDS).MethodsThirty preterm neonates with RDS transferred from our obstetrics department to the neonatal intensive care unit were selected prospectively.Lung ultrasound was performed and scored before and after PS use at 6 h,12 h,18 h,and 24 h,dynamic changes of lung ultrasound and its score at different times were observed.ResultsBefore PS use,16 cases(53.3%)showed bilateral white lung by lung ultrasound,14 cases(46.7%)showed alveolar interstitial syndrome,and 11 cases(36.7%)showed subpleural lung consolidation.After PS use at 6 h,3 cases(10.0%)showed bilateral white lung,and 2 cases(6.7%)showed subpleural lung consolidation,which was significantly better than that before PS use.The differences were statistically significant(χ^2=11.09,6.29,P=0.001,0.012).After PS use at 12 h,18 h,and 24 h,bilateral white lung and lung consolidation were not observed by lung ultrasound in all preterm neonates with RDS.Compared with before PS use,the difference was statistically significant(χ^2=19.18,P<0.001),but the difference was not statistically significant compared with that after PS use at 6 h(χ^2=1.40,P=0.24).The lung ultrasound scores at 6 h,12 h,18 h,and 24 h after the PS use were 19.3±4.0,17.4±3.9,17.6±4.0,and 17.9±4.2,respectively,which were lower than that before PS use(22.3±2.6),and the differences were statistically significant(all P<0.05).However,the differences of lung ultrasound score after PS use at 6 h,12 h,18 h,and 24 h were not statistically significant.ConclusionLung ultrasoundcan dynamically evaluate the effect of PS in the treatment of preterm neonates with RDS.The pulmonary condition can be improved significantly by lung ultrasound after PS use at 6 h.

关 键 词：超声检查 早产儿 呼吸窘迫综合征 肺表面活性物质 

分 类 号：R445.1[医药卫生—影像医学与核医学]