肺部超声联合超声心动图在小儿急性呼吸窘迫综合征中的诊断价值  

Diagnostic value of lung ultrasound combined with echocardiography in pediatric acute respiratory distress syndrome

作　　者：路红涛[1] 刘丽 LU Hongtao;LIU Li(Ultrasonography Department,Hancheng People's Hospital,Hancheng 715400;Critical Care Medicine Department,Gaoling District Hospital,Xi'an 710200,China)

机构地区：[1]韩城市人民医院超声科,陕西韩城715400 [2]高陵区医院重症医学科,陕西西安710200

出　　处：《临床医学研究与实践》2022年第32期94-97,102,共5页Clinical Research and Practice

基　　金：陕西省社会发展科技攻关项目(No.2019SF-106)。

摘　　要：目的分析肺部超声联合超声心动图在小儿急性呼吸窘迫综合征(PARDS)中的诊断价值。方法选择2019年4月至2021年10月我院收治的80例以呼吸困难为主要症状的儿科重症监护病房(PICU)患儿,所有患儿入院24 h内均行胸部X线、肺部超声、超声心动图检查。根据儿童急性肺损伤共识会议(PALICC)所制定的PARDS诊断标准作为金标准,将患儿分为A组(PARDS,55例)和B组(非PARDS,25例)。比较两组的一般资料;分析肺部超声联合超声心动图和单一肺部超声诊断结果、病情严重程度与金标准之间的差异,并分析诊断价值;分析PARDS患儿治疗前、后的肺部超声情况。结果A组的左室射血分数(LVEF)和肺部超声评分均显著高于B组(P<0.05)。肺部超声联合超声心动图检出真阳性53例,高于单一肺部超声检出真阳性46例;肺部超声联合超声心动图检出真阴性24例,高于单一肺部超声检出真阴性20例,提示肺部超声联合超声心动图诊断结果优于单一肺部超声。肺部超声联合超声心动图诊断轻度、中度、重度患儿分别为22、23、10例,单一肺部超声诊断轻度、中度、重度患儿分别为22、21、12例,提示肺部超声联合超声心动图诊断病情严重程度的结果优于单一肺部超声。肺部超声联合超声心动图诊断的灵敏度、特异度、阳性预测值、阴性预测值均高于单一肺部超声检测。经临床积极治疗,72 h后复查肺超声检查,患儿肺实变及支气管充气征减轻,胸膜线逐渐清晰,A线逐渐出现,肺滑动征存在,胸腔积液亦明显减少。结论肺部超声联合超声心动图检测可以提高PARDS的临床诊断率,且肺部超声在患儿的恢复检查中起到了辅助作用,具有较好的临床应用价值。Objective To analyze the diagnostic value of lung ultrasound combined with echocardiography in pediatric acute respiratory distress syndrome(PARDS).Methods A total of 80 pediatric intensive care unit(PICU)children with dyspnea as the main symptom admitted in our hospital from April 2019 to October 2021 were selected,all children were examined by chest X-ray,lung ultrasound and echocardiography within 24 h after admission.The children were divided into group A(PARDS,55 cases)and group B(non-PARDS,25 cases)according to the PARDS diagnostic standard formulated by the Pediatric Acute Lung Injury Consensus Conference(PALICC)as the gold standard.The general data of the two groups were compared;the diagnostic results of lung ultrasound combined with echocardiography and single lung ultrasound,the difference between the severity of disease and the gold standard were analyzed,and the diagnostic value was analyzed;the lung ultrasound of PARDS children before and after treatment were compared.Results The left ventricular ejection fraction(LVEF)and lung ultrasound score in the group A were significantly higher than those in the group B(P<0.05).Lung ultrasound combined with echocardiography showed true positive in 53 cases,which was higher than that of single lung ultrasound in 46 cases;lung ultrasound combined with echocardiography showed true negative in 24 cases,which was higher than that of single lung ultrasound in 20 cases,it is suggested that the diagnostic results of lung ultrasound combined with echocardiography was better than that of single lung ultrasound.There were 22,23 and 10 cases of mild,moderate and severe children diagnosed by lung ultrasound combined with echocardiography,and 22,21 and 12 cases of mild,moderate and severe children diagnosed by single lung ultrasound,it is suggested that lung ultrasound combined with echocardiography was superior to single lung ultrasound in the diagnosis of severity of the disease.The sensitivity,specificity,positive predictive value and negative predictive value of lung u

关 键 词：小儿急性呼吸窘迫综合征 肺部超声 超声心动图 

分 类 号：R814.4[医药卫生—影像医学与核医学]