近足月-足月儿生后早期肺部生理征象的超声特征分析  

Lung ultrasound characteristics of late preterm and term infants shortly after birth

作　　者：张睿洁 郤冠楠 林昕奥 樊晓波 汪吉梅[1] ZHANG Ruijie;XI Guannan;LIN Xin'ao;FAN Kiaobo;WANG Jimei(Department of Neonatology,Obstetrics and Gynecology Hospial of Fudan University,Shanghai 200001,China)

机构地区：[1]复旦大学附属妇产科医院新生儿科,上海200001

出　　处：《中国优生与遗传杂志》2024年第4期833-837,共5页Chinese Journal of Birth Health & Heredity

基　　金：上海市卫生健康委员会项目(202040402)。

摘　　要：目的研究足月儿或近足月儿生后早期“宫内-宫外”转换期间肺部超声图像特征和变化规律。方法采集2019年4—12月于复旦大学附属妇产科医院出生的466名足月儿或近足月儿肺部超声图像。检查的时间点为生后0.5 h、1.0 h、2.0 h和4.0 h;保留3 d后未发生肺部疾病的新生儿作为研究对象,回顾性分析他们出生时采集的图像。结果最终纳入393例无肺部疾病新生儿的肺部超声图像,分别有109例于生后0.5 h;107例于生后1.0 h;141例于生后2.0 h;36例于生后4.0 h采集超声图像。无肺部疾病的足月儿或近足月儿肺部超声的征象主要有3种:“单纯A-线”“散在B-线”和“融合B-线”。其中“融合B-线”和“散在B-线”随时间逐渐减少(P<0.001);而“单纯A-线”则逐渐增多(P<0.001)。生后1 h内有两例新生儿出现“融合B线”,分别于生后0.5 h和1 h各有1例。结论肺部超声可以动态观察足月儿或近足月儿生后早期肺部生理征象,主要有3种:“单纯A-线”“散在B-线”和“融合B-线”。需要被临床医生所重视,以免造成过度治疗。Objective To observe the characteristics and evolution of lung ultrasound images in late preterm and term infants during the intrauterine-to-extrauterine environmental transition stage.Methods Lung ultrasound images of 466 late preterm or term neonates born in Obstetrics and Gynecology Hospital of Fudan University from April to December 2019 were collected.Lung ultrasound was performed at one of following timings after birth:0.5 h,1.0 h,2.0 h and 4.0 h and images were saved.The neonates without the respiratory system disorders(conformed by a three-day follow-up)were enrolled in.Their images were retrospectively analyzed.Results A total of 393 neonates without the respiratory system diseases were eligible.The number of images was 109,107,141,and 36 of 0.5 h,1.0 h,2.0 h,and 4.0 h after birth.We found mainly three signs in their images:“A-line”,“Distribute B-line”and“Coalesced B-line”.While the number of“Distribute B-line”and“Coalesced B-line”were decreased(P<0.001),“A-line”were increased over the time(P<0.001).The“Coalesced B-line”sign was found in two infants,respectively at 0.5 h and 1 h.Conclusion LUS is available to observe the physiological images of the late preterm and term infants shortly after birth.The most common characteristics include“A-line”,“Distribute B-line”and“Coalesced B-line”.These clues may be useful to avoid unnecessary treatment in LUS guided treatment protocol.

关 键 词：肺 超声检查 足月儿 近足月儿 生理征象 

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