肺超声12分区评分法在NRDS患儿机械通气治疗中的预测价值  

Predictive value of 12-zone lung ultrasound scoring method in NRDS children with mechanical ventilation

作　　者：梁振宇[1] 孟琼[1] 游楚明[1] 吴碧君[2] 吴倩梅 李霞 LIANG Zhen-yu;MENG Qiong;YOU Chu-ming;WU Bi-jun;WU Qian-mei;LI Xia(Department of Pediatrics,Guangdong Second Provincial General Hospital,Guangzhou,Guangdong 510220,China;不详)

机构地区：[1]广东省第二人民医院儿科,广东广州510220 [2]广东省第二人民医院超声科,广东广州510220

出　　处：《中国临床研究》2021年第11期1465-1469,共5页Chinese Journal of Clinical Research

基　　金：广东省医学科研基金项目(A2020064)。

摘　　要：目的探讨肺超声12分区评分法在新生儿呼吸窘迫综合征(NRDS)机械通气治疗中的预测价值,为临床治疗提供依据。方法选择2018年4月至2019年5月广东省第二人民医院诊断为NRDS的患儿580例作为研究对象,在首次X线胸片检查2 h内完成肺超声12分区评分,并根据病情的严重程度采取不同的辅助通气模式。采用Spearman相关分析肺超声评分与X线分级、辅助通气模式分级的相关性;绘制ROC曲线评价肺超声12分区评分法在NRDS患儿机械通气中的预测效能。结果随着X线分级和辅助通气模式分级的递升,NRDS患儿肺超声12分区评分均递增,差异有统计学意义(P<0.01,P<0.05)。Spearman相关性分析提示,肺超声12分区评分与NRDS患儿X线分级呈正相关(r=0.692,P<0.01);不同辅助通气模式与X线分级呈正相关(r=0.724,P<0.01)。肺超声评分对NRDS患儿需要机械通气的预测效能,当临界值为12.76分时,预测灵敏度为0.871,特异度为0.637,AUC值为0.867。结论肺超声12分区评分法可用于预测NRDS患儿机械通气治疗的使用,并与X线分级存在一定相关性。Objective To explore the predictive value of 12-zone lung ultrasound score method in the treatment of neonatal respiratory distress syndrome(NRDS)with mechanical ventilation to provide a basis for clinical treatment.Methods A total of 580 children diagnosed with NRDS in Guangdong Second Provincial General Hospital from April 2018 to May 2019 were selected as the research subjects.Within 2 hours after the first chest X-ray examination,12-zone lung ultrasound score was finished,and different auxiliary ventilation methods were performed according to the severity of the disease.Spearman correlation was used to analyze the associations of pulmonary ultrasound score with X-ray classification and auxiliary ventilation mode.ROC curve was drawn to pre-evaluate the predictive efficacy of 12-zone lung ultrasound score method in mechanical ventilation of children with NRDS.Results With the increases of X-ray grading and the upgrade of auxiliary ventilation mode,12-zone lung ultrasound scores increased respectively,the difference was statistically significant(P<0.01,P<0.05).Spearman correlation analysis showed that there were positive correlations between pulmonary ultrasound 12 zone score and X-ray grade(r=0.692,P<0.01)and between auxiliary ventilation modes and X-ray grade(r=0.724,P<0.01).For the predictive efficacy of 12-zone lung ultrasound scoring method,the area under the ROC curve(AUC)was 0.867,with predictive sensitivity of 0.871 and specificity of 0.637,when the critical value was 12.76.Conclusions Lung ultrasound using 12-zone method can be used to predict the application of mechanical ventilation in children with NRDS.There is a certain correlation between 12-zone lung ultrasound scoring and X-ray classification.

关 键 词：新生儿呼吸窘迫综合征 肺超声评分 机械通气 预测效能 X线分级 辅助通气模式 

分 类 号：R722[医药卫生—儿科]