床旁肺部超声诊断新生儿胎粪吸入综合征  

Bedside lung ultrasonography for diagnosing neonatal meconium aspiration syndrome

作　　者：徐振宏[1] 王泽城 颜丽笙[2] 颜小斌 XU Zhenhong;WANG Zecheng;YAN Lisheng;YAN Xiaobin(Department of Ultrasound,Second Affiliated Hospital,Fujian Medical University,Quanzhou 362000,China;Department of Radiology,Second Affiliated Hospital,Fujian Medical University,Quanzhou 362000,China)

机构地区：[1]福建医科大学附属第二医院超声科,福建泉州362000 [2]福建医科大学附属第二医院放射科,福建泉州362000

出　　处：《中国医学影像技术》2021年第10期1482-1485,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察床旁肺部超声检查(LUS)诊断新生儿胎粪吸入综合征(MAS)的价值。方法收集56例MAS新生儿(MAS组)和70名健康新生儿(对照组),对比2组临床资料及床旁LUS表现。结果MAS组与对照组新生儿性别、年龄、体质量及出生情况差异均无统计学意义(P均>0.05)。对照组新生儿LUS示胸膜线呈光滑清晰的线状强回声,随呼吸运动而水平滑动;A线呈线状强回声,彼此平行、间隔相等;每个肺野未见或仅见1~2条B线;未见胸腔积液或肺实变等异常征象。MAS组LUS均见双肺散在大小不等、边界不清的中低回声及点状或线状高回声,即肺实变伴支气管充气征;部分患儿胸膜线消失或增厚、模糊,肺部实变区未见A线,非实变区可见多条B线;8例(8/56,14.29%)可见肺实变伴肺搏动征,8例(8/56,14.29%)存在胸腔积液。结论床边LUS可用于诊断新生儿MAS;超声发现双肺实变伴支气管充气征高度提示新生儿MAS。Objective To observe the value of bedside lung ultrasonography(LUS)for diagnosing neonatal meconium aspiration syndrome(MAS).Methods Fifty-sixth newborns with MAS(MAS group)and 70 healthy newborns(control group)were enrolled.The clinical data and bedside LUS manifestations were compared between 2 groups.Results There was no significant difference of gender,age,body mass nor birth status between groups(all P>0.05).In control group,LUS found smooth and clear linear strong echo of pleural line sliding horizontally with respiratory movement,and line A present as linear strong echo,parallel to each other and equally spaced,no or only 1—2 line B in each lung field,without abnormality such as pleural effusion and lung consolidation,etc.In MAS group,LUS detected scattered medium and low echoes with different sizes and unclear boundaries,as well as dot or liner hyperechoes indicating lung consolidation with bronchial inflation,and the pleural line of some cases disappeared or thickened and blurred.No line A was found in lung consolidation,while multiple line B were found in non-consolidation area.Eight cases(8/56,14.29%)of MAS group were found with pulmonary consolidation and pulmonary pulsation sign,while pleural effusion was detected in 8 cases(8/56,14.29%).Conclusion Bedside LUS could be used for diagnosis of MAS.LUS manifestations of double lung consolidation with bronchial inflation sign highly indicated neonatal MAS.

关 键 词：胎粪吸入综合征 婴儿 新生儿 超声检查 

分 类 号：R722.19[医药卫生—儿科] R445.1[医药卫生—临床医学]