肺部超声技术对新生儿肺部疾病的鉴别诊断价值研究  

Study on the value of pulmonary ultrasound in differential diagnosis of neonatal pulmonary diseases

作　　者：张国清 李薇 陈葵带 ZHANG Guoqing;LI Wei;CHEN Kuidai(Department of Neonatology,Dongguan Binhai Bay Central Hospital,Dongguan 5th People’s Hospital,Guangdong,Dongguan 523000,China)

机构地区：[1]广东省东莞市滨海湾中心医院,广东省东莞市第五人民医院新生儿科,广东东莞523000

出　　处：《中国医药科学》2024年第22期68-71,共4页China Medicine And Pharmacy

基　　金：广东省东莞市社会发展科技项目(20231800937112)。

摘　　要：目的探讨肺部超声技术对新生儿肺部疾病鉴别诊断的价值。方法选取2023年5月至2024年3月东莞市滨海湾中心医院诊治的80例疑似肺部疾病新生儿为研究对象,对肺部超声技术在疾病诊断中的应用展开分析,并以患儿最终诊断结果为标准,计算肺部超声技术在新生儿各种肺部疾病中的诊断效能。结果最终诊断结果显示,80例疑似肺部疾病患儿中有69例患儿确诊为肺部疾病,其中34例呼吸窘迫综合征(RDS)、24例肺炎、6例新生儿胎粪吸入综合征(MAS)、5例新生儿湿肺(TTN);还有11例患儿确诊为非肺部疾病。肺部超声在新生儿肺炎诊断中的敏感度、特异度分别为87.50%、98.21%。肺部超声在RDS诊断中的敏感度、特异度分别为94.12%、95.65%。肺部超声在MAS诊断中的敏感度、特异度分别为83.33%、100.00%。肺部超声在TTN诊断中的敏感度、特异度分别为80.00%、100.00%。新生儿肺炎、RDS、MAS、TTN共同有胸膜线异常、A线消失的超声表现。其中新生儿肺炎、RDS还存在肺实变伴支气管充气征,MAS可伴有支气管充气征,TTN不伴有支气管充气征。结论肺部超声技术在新生儿肺部疾病的鉴别诊断中具有较高的价值,可帮助临床及早判断疾病类型,减少对新生儿的搬动,使患儿及早得到规范治疗。Objective To explore the value of pulmonary ultrasound in differential diagnosis of neonatal pulmonary diseases.Methods A total of 80 newborns with suspected lung diseases diagnosed and treated in Dongguan Binhai Bay Central Hospital from May 2023 to March 2024 were selected as the subjects,and the application of pulmonary ultrasound technology in disease diagnosis was analyzed.The diagnostic efficiency of pulmonary ultrasound technology in various neonatal lung diseases was calculated based on the final diagnosis results of children.Results The final diagnosis results showed that there were 80 children suspected of having lung disease,and 69 children were ultimately diagnosed with lung disease.Among them,34 cases were respiratory distress syndrome(RDS),24 cases were pneumonia,6 cases were meconium aspiration syndrome(MAS),and 5 cases were transient tachypnea of the newborn(TTN).There were also 11 children with non-pulmonary diseases.The sensitivity and specificity of pulmonary ultrasound in the diagnosis of neonatal pneumonia are 87.50%and 98.21%,respectively.The sensitivity and specificity of pulmonary ultrasound in the diagnosis of RDS are 94.12%and 95.65%,respectively.The sensitivity and specificity of pulmonary ultrasound in MAS diagnosis are 83.33%and 100.00%,respectively.The sensitivity and specificity of pulmonary ultrasound in TTN diagnosis are 80.00%and 100.00%,respectively.Newborns with pneumonia,RDS,MAS,and TTN had common ultrasonic manifestations of abnormal pleural line and disappearance of A line.Among them,neonatal pneumonia and RDS also had pulmonary solid changes with bronchial inflation sign,MAS may be accompanied by bronchial inflation sign,TTN was not accompanied by bronchial inflation sign.Conclusion Pulmonary ultrasound technology has high value in the differential diagnosis of neonatal pulmonary diseases,which can help the clinic to judge the types of diseases as early as possible,reduce the moving of newborns,and make the children get standardized treatment as early as possible.

关 键 词：肺部超声 新生儿 肺部疾病 肺炎 新生儿胎粪吸入综合征 

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]