心肺联合重症超声在评估极低体重早产儿预后的应用价值  

Application Value of Cardio⁃pulmonary Cmbined with Severe Ultrasound in Evaluating the Prognosis of Very Low Birth Weight Premature Infants

作　　者：黎天明 李性希[1] 史妙丽 杨春晖[2] 张碧宏[1] LI Tian-ming;LI Xing-xi;SHI Miao-li;YANG Chun-hui;ZHANG Bi-hong(Department of Ultrasound,Boai Hospital,Zhongshan,Guangdong,528400;Department of Neonatology,Boai Hospital,Zhongshan,Guangdong)

机构地区：[1]广东省中山市博爱医院超声科,528400 [2]广东省中山市博爱医院新生儿科,528400

出　　处：《岭南急诊医学杂志》2023年第2期126-129,共4页Lingnan Journal of Emergency Medicine

基　　金：中山市社会公益与基础研究项目(2021B1092)。

摘　　要：目的:探讨心肺联合重症超声在评估极低体重早产儿预后的应用价值。方法:选取2021年6月至2022年9月广东省中山市博爱医院新生儿科的极低体重早产儿192例作为研究对象,在出生后24 h内对其进行心肺联合重症超声检查。将其根据预后情况分为预后良好组135例和预后不良组57例,对比分析两组患儿的心肺重症超声评估内容及临床参数,多因素Logistic回归分析极低体重早产儿预后不良的影响因素,ROC曲线分析血流动力学参数、LUS评分、相关临床参数对极低体重早产儿预后不良的预测价值。结果:预后不良组TAPSE低于预后良好组,LUS评分、PaCO_(2)高于预后良好组,差异均具有统计学意义(P<0.05);多因素Logistic回归分析,低TAPSE、高LUS评分以及高PaCO_(2)是极低体重早产儿预后不良的影响因素;ROC曲线分析显示,TAPSE、LUS评分、PaCO_(2)单独及联合预测的AUC分别为0.752、0.737、0.765、0.826,联合检测的灵敏度、特异度均较高。结论:心肺联合重症超声对评估极低体重早产儿预后具有一定临床价值。Objective:To explore the application value of cardio⁃pulmonary combined with severe ultrasound in evaluating the prognosis of very low birth weight premature infants.Methods:From June 2021 to September 2022,192 extremely low weight premature infants from the Department of Neonatology,Boai Hospital,Zhongshan City,Guang⁃dong Province were selected as the study subjects,and they were examined by cardio⁃pulmonary combined with severe ultrasound within 24 hours after birth.According to the prognosis,the patients were divided into good prognosis group(135 cases)and poor prognosis group(57 cases).The contents and clinical parameters of cardio⁃pulmonary critical ul⁃trasound evaluation in the two groups were compared and analyzed.The factors influencing the poor prognosis of VLBW premature infants were analyzed by multivariate logistic regression,and the predictive value of hemodynamic parame⁃ters,LUS scores,and related clinical parameters on the poor prognosis of VLBW premature infants was analyzed by ROC curve.Results:The TAPSE in the poor prognosis group was lower than that in the good prognosis group,and the LUS score and PaCO_(2)were higher than those in the good prognosis group,with statistical significance(P<0.05);Multi⁃variate logistic regression analysis showed that low TAPSE,high LUS score and high PaCO_(2)were the factors influencing the poor prognosis of VLBW premature infants;ROC curve analysis showed that the AUC predicted by TAPSE,LUS score and PaCO_(2)alone and jointly were 0.752,0.737,0.765 and 0.826,respectively.The sensitivity and specificity of combined detection were high.Conclusion:Cardiopulmonary combined with severe ultrasound has certain clinical value in evaluating the prognosis of VLBW premature infants.

关 键 词：心肺联合重症超声 极低体重早产儿 预后评估 

分 类 号：R445.1[医药卫生—影像医学与核医学] R722.6[医药卫生—诊断学]