小儿肺超声在社区获得性肺炎中的应用价值  

Application value of pediatric lung ultrasound in diagnosis of community acquired pneumonia

作　　者：刘群 房秀霞[1] 樊炳慧 刘笑笑 LIU Qun;FANG Xiu-xia;FAN Bing-hui;LIU Xiao-xiao(Department of Ultrasound Medicine,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 750306,Inner Mongolia,China)

机构地区：[1]内蒙古医科大学附属医院超声医学科,内蒙古呼和浩特750306

出　　处：《生物医学工程与临床》2024年第3期338-342,共5页Biomedical Engineering and Clinical Medicine

基　　金：内蒙古自治区自然科学基金项目(2021LHMS08049);内蒙古医科大学青年项目(YKD2024QN018)。

摘　　要：目的比较小儿肺超声(PLUS)和胸部X射线片(CXR)在社区获得性肺炎(CAP)住院患儿中的诊断准确度,探讨PLUS在CAP患儿病情评估中的应用。方法选择依据《儿童社区获得性肺炎诊疗规范(2019版)》确诊CAP住院患儿153例,其中男性99例,女性54例;年龄3~60个月,平均年龄24.80个月;体质量15.3~16.8 kg,平均体质量16.41 kg;咳嗽、呼吸困难115例,呼吸困难93例;肺炎58例,重症肺炎95例。CXR和PLUS分别在入院6 h内完成。分析两种方法的影像表现,比较诊断准确度。结果PLUS异常145例(94.77%),CXR异常131例(85.62%)。在CXR诊断为肺炎的患儿中,有125例(125/131;95.42%)患儿检出PLUS异常,22例肺炎患儿CXR表现阴性时,其中20例[20/22(90.91%)]患儿检出PLUS异常。PLUS的灵敏度为94.77%,特异度为94.44%。CXR的灵敏度为85.62%,特异度为92.59%。结论PLUS是一项灵敏度和特异度均较高的检查,可作为CAP患儿在CXR前的首选检查。Objective To compare the diagnostic accuracy of pediatric lung ultrasound(PLUS)and chest X-ray(CXR)in hospitalized children with community acquired pneumonia(CAP),and explore the application of PLUS in evaluation of CAP children.Methods A total of 153 hospitalized children with CAP diagnosed according to Guidelines for Diagnosis and Treatment of Community-Acquired Pneumonia in Children(2019 Edition)were enrolled,which included 99 males and 54 females,aged 3-60 months with mean age of 24.80 months,body mass was 15.3-16.8 kg with mean body mass of 16.41 kg;115cases of cough and dyspnea and 93 of dyspnea;58 cases of pneumonia and 95 of severe pneumonia.The CXR and PLUS examinations were completed within 6-hour after admission.The imaging manifestations of the two methods were analyzed and the diagnostic accuracy was compared.Results The clinical diagnosis results showed 145 cases of PLUS abnormality(94.77%)and 131 cases of CXR abnormality(85.62%).Among the children diagnosed with pneumonia by CXR,125 cases(125/131,95.42%)were detected abnormal by PLUS,and 22 cases of pneumonia showed negative CXR,of which 20 cases(20/22,90.91%)were detected abnormal by PLUS.The sensitivity of PLUS was 94.77%and specificity was 94.44%.The sensitivity of CXR was 85.62%and specificity was 92.59%.Conclusion It is demonstrated that PLUS shows higher sensitivity and specificity,which can be used as the preferred examination for CAP children before CXR.

关 键 词：儿童 肺超声 社区获得性肺炎 胸部X射线(CXR) 

分 类 号：R725.6[医药卫生—儿科] R445.1[医药卫生—临床医学]