肺脏超声表现及相关评分在新生儿呼吸窘迫综合征临床定性中的研究  

Study of ultrasound manifestation of lung and the related scores in clinically qualitative analysis of neonatal RDS

作　　者：郑旭 赵红敏 张明哲 贾立杨 吕君 李斐然 ZHENG Xu;ZHAO Hong-min;ZHANG Ming-zhe(不详;Department of Ultrasound,Yihe Branch Hospital of Cangzhou People's Hospital,Cangzhou 061000,China)

机构地区：[1]沧州市人民医院颐和院区超声科,河北沧州061000 [2]沧州市中心医院心电检查科,河北沧州061000

出　　处：《中国医学装备》2023年第9期76-81,共6页China Medical Equipment

基　　金：河北省卫生健康委青年科技课题(20220322)“肺脏超声表现及评分在新生儿呼吸窘迫综合征的临床应用”。

摘　　要：目的:探讨肺脏超声在新生儿呼吸窘迫综合征(RDS)中的诊断价值及与病情程度的相关性。方法:选取医院收治并确诊的100例RDS新生儿纳入RDS组,另选取100名无肺部疾患的新生儿纳入健康对照组,对比两组新生儿的肺部超声特征、肺脏超声评分及血气参数。根据新生儿呼吸窘迫评分法再将RDS组分为轻中度组(67例)和重度组(33例),对比RDS组与健康对照组及RDS各亚组患儿肺脏超声特征及评分以及血气参数的差异;采用简单线性相关分析法分析肺脏超声评分与血气参数的相关性。结果:RDS组肺实变、支气管充气征、胸膜线异常、A线消失、白肺以及胸腔积液的检出率显著高于健康对照组,差异具有统计学意义(x^(2)=72.109,x^(2)=17383,x^(2)=74.261,x^(2)=53.888,x^(2)=31.214,x^(2)=13.085;P<0.05);RDS组肺脏超声评分(LUS)、动脉血二氧化碳分压(PaCO_(2))值显著高于健康对照组,动脉血氧分压(PaO_(2))、氧合指数(OI)值显著低于健康对照组,差异具有统计学意义(t=33.724,t=-55.603,t=44.674;P<0.05)。重度组RDS患儿肺实变、支气管充气征、胸膜线异常、A线消失、白肺以及胸腔积液的检出率显著高于轻中度组RDS患儿,差异具有统计学意义(x^(2)=10.240,x^(2)=28.836,x^(2)=9.711,x^(2)=18.050,x^(2)=33.541,x^(2)=17.505;P<0.05)。重度组RDS患儿LUS和PaCO_(2)值显著高于轻中度组RDS患儿,PaO_(2)、OI值显著低于轻中度组RDS患儿,差异具有统计学意义(t=-7.373,t=7.556,t=-7.985,t=7.618;P<0.05)。RDS患儿LUS与PaCO_(2)值呈显著正相关(r=0.574,P<0.05),与PaO_(2)、OI呈显著负相关(r=-0.661,r=-0.704;P<0.05)。结论:肺脏超声特征可在临床对RDS患儿进行诊断,而LUS与患儿病情程度和缺氧程度密切相关。Objective:To explore the value of lung ultrasound in diagnosing neonatal respiratory distress syndrome(RDS)and the relationship of that with the severity of the disease.Methods:A total of 100 RDS newborns who admitted and were confirmed in hospital were selected as the RDS group,and another 100 newborns without lung diseases were selected as the healthy control group.The ultrasound characteristics and ultrasound scores of lung,blood gas parameters of the two groups of newborns were compared.According to the neonatal respiratory distress score method,the RDS group was further divided into mild to moderate group(67 cases)and severe group(33 cases).The differences in ultrasound characteristics and scores of lung,and blood gas parameters between the RDS group and the healthy group,as well as between different RDS subgroups were compared.The simple linear correlation analysis method was adopted to analyze the correlation between ultrasound scores of lung and blood gas parameters.Results:The detection rates of lung consolidation,bronchial inflation sign,abnormal pleural line,disappearance of A-line,white lung and pleural effusion in RDS group were significantly higher than those in healthy control group,with statistical significance(x^(2)=72.109,x^(2)=17383,x^(2)=74.261,x^(2)=53.888,x^(2)=31.214,x^(2)=13.085,P<0.05),respectively.The lung ultrasound score(LUS)and arterial partial pressure of carbon dioxide(PaCO_(2))values in the RDS group were significantly higher than those in the healthy control group,while arterial partial pressure of oxygen(PaO_(2))and oxygenation index(OI)values were significantly lower than those in the healthy control group,with statistically significant differences(t=33.724,t=-55.603,t=44.674,P<0.05),respectively.The detection rates of lung consolidation,bronchial inflation sign,abnormal pleural line,disappearance of A-line,white lung and pleural effusion in severe RDS group were significantly higher than those in mild to moderate RDS group,with statistically significant difference(x^(2)=10.240,

关 键 词：肺脏超声 诊断 新生儿呼吸窘迫综合征(RDS) 血气参数 

分 类 号：R445.1[医药卫生—影像医学与核医学]