应用床旁肺部超声动态观察珂立苏气管内滴入治疗新生儿肺透明膜病的效果  

Effect of bedside lung ultrasound to dynamically observe the effect of intratracheal instillation of Calsurf in the treatment of neonatal hyaline membrane disease

作　　者：何必子[1] 刘登礼[1] HE Bi-zi;LIU Deng-li(Department of Pediatrics,First Affiliated Hospital of Xiamen University,Xiamen 361003,China)

机构地区：[1]厦门大学附属第一医院儿科,厦门市儿科重点实验室,厦门大学医学院儿童医学研究所,361003

出　　处：《中国现代药物应用》2023年第10期50-52,共3页Chinese Journal of Modern Drug Application

基　　金：2019年厦门市科技局卫生指导性项目(项目编号:3502Z20199008)。

摘　　要：目的 应用床旁肺部超声动态观察注射用牛肺表面活性剂(商品名:珂立苏)气管内滴入治疗新生儿肺透明膜病的效果。方法 33例新生儿肺透明膜病患儿,使用床旁肺部超声监测应用珂立苏前及应用珂立苏后2、6 h的超声图像变化。分析患儿应用珂立苏前的胸片与肺部超声表现,应用珂立苏前后肺部超声表现,比较应用珂立苏前后肺部超声评分。结果 9例胸片Ⅰ级患儿的肺部超声以B线(9例)表现为主;18例胸片Ⅱ级患儿的肺部超声以支气管充气征(13例)表现为主;6例胸片Ⅲ级及以上患儿的肺部超声以白肺(2例)和更明显支气管充气征(4例)为主。应用珂立苏后2、6 h,胸膜线异常、肺实变、白肺、支气管充气征、B线均较应用珂立苏前减少,A线较应用珂立苏前增多。患儿应用珂立苏前及应用珂立苏后2、6 h的肺部超声评分分别为(12.36±1.44)、(6.90±2.16)、(6.54±1.74)分。患儿应用珂立苏后2、6 h的肺部超声评分均低于应用珂立苏前,差异具有统计学意义(P<0.05);患儿应用珂立苏后2 h与6 h的肺部超声评分比较,差异无统计学意义(P>0.05)。结论 床旁肺部超声可用来评估珂立苏治疗新生儿肺透明膜病的疗效。Objective To observe the effect of bedside lung ultrasound to dynamically observe the effect of intratracheal instillation of calf pulmonary surfactant for injection(trade name:Calsurf)in the treatment of neonatal hyaline membrane disease.Methods 33 neonates with hyaluronic membrane disease were monitored by bedside ultrasound,and the changes in ultrasonic images were observed before and after Calsurf for 2 and 6 h.The chest radiographs and lung ultrasound findings before the application of Calsurf,and the lung ultrasound findings before and after the application of Calsurf were analyzed,and the lung ultrasound scores was compared before and after the application of Calsurf.Results The lung ultrasound of 9 children with gradeⅠchest radiography was mainly performed by B-line(9 cases);air bronchogram(13 cases)was the main manifestation of lung ultrasound in 18 children with gradeⅡchest radiography;in 6 cases with gradeⅢor above chest radiography,white lung(2 cases)and more obvious air bronchogram(4 cases)were the main types of lung ultrasound.2 and 6 h after the application of Calsurf,the abnormal pleural line,lung consolidation,white lung,air bronchogram and line B were reduced compared with that before the application of Calsurf,and line A was increased compared with that before the application of Calsurf.The lung ultrasound scores of the children before the application of Calsurf and 2 and 6 h after the application of Calsurf were(12.36±1.44),(6.90±2.16),and(6.54±1.74)points.The lung ultrasound scores of the children at 2 and 6 h after the application of Calsurf were lower than those before the application of Calsurf,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the lung ultrasound scores at 2 and 6 h after the application of Calsurf(P>0.05).Conclusion Bedside lung ultrasound can be used to evaluate the efficacy of Calsurf in the treatment of neonatal hyaline membrane disease.

关 键 词：床旁肺部超声 肺透明膜病 注射用牛肺表面活性剂 效果 

分 类 号：R722.1[医药卫生—儿科]