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新生儿重症肺炎患儿床旁超声的应用价值
高 虹1,2
1.(1)昆明医科大学附属儿童医院超声科,云南 昆明 650228;2)云南省科学技术院,云南 昆明 650228)
摘要:
[摘要]目的 分析新生儿重症肺炎患儿的超声影像特点,探讨床旁超声诊断重症肺炎的临床价值.方法 以2015年10月至2016年3月新生儿科的59例重症肺炎患儿为研究对象,根据胸部X线(CXR)特点分为实变组(双肺广泛斑片状影或伴支气管充气征或肺段分布的致密阴影)和非实变组(表现为双肺纹理增粗、模糊或小斑片样改变),比较2组患儿肺部超声影像的差异.结果 新生儿重症肺炎患儿超声影像特点为肺实变伴支气管充气征,A线消失,胸膜线模糊或消失等.X线实变组23例患儿中有21例超声检查有实变表现,X线非实变组36例患儿超声检查均无肺实变表现.2组比较差异无统计学意义(P>0.05).超声A线检测实变组中20例A线消失,非实变组中37例A线消失,2组比较差异无统计学意义(P>0.05).超声胸膜线检测实变组11例胸膜线模糊或消失,非实变组15例胸膜线模糊或消失,2组比较差异无统计学意义(P>0.05).结论 新生儿重症肺炎患儿的超声影像特点包括肺实变伴支气管充气征、A线消失、胸膜线改变等.可作为评价肺炎的诊断方法.
关键词:  [关键词]新生儿  重症肺炎  超声检查
DOI:
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基金项目:[基金项目]昆明市科技局科技计划项目(2015-1-S-00510)
Application Value of Bedside Ultrasound in Diagnosis of Neonatal Severe Pneumonia
GAO Hong1,2
1.(1)Dept. of Ultrasonography,The Affiliated Children's Hospital of Kunming Medical University,Kunming Yunnan 650228;2)Yunnan Provincial Academy of Science and Technology,Kunming Yunnan 650228,China)
Abstract:
[Abstract]Objective To evaluate the application value of bedside lung ultrasound in diagnosis of neonatal severe pneumonia.Methods Bedside lung ultrasound and chest X-ray were performed in 59 the newborn patients admitted to the newborn department for suspected severe pneumonia,from October 2015 to March 2016.According to the characteristics of the chest X-ray,patients were divided into consolidation group(widely spot shadow in double lung and airbronchograms)and the unconsolidation group( enlargement,fuzzy texture in double lung or small patch sample changes).Differences in ultrasonic characteristics were compared between the two groups. Results Ultrasonic image characteristics were pulmonary consolidation with air bronchograms,A-line disappearance,pleural line abnormalities. Among 23 patients with chest X-ray,21 patients were found pulmonary consolidation by lung ultrasound,and all 36 patients in unconsolidation group were not found pulmonary consolidation by lung ultrasound,and there was no significant difference in the detection rate by lung ultrasound between the two groups(P>0.05).The pulmonary ultrasound results of 20 cases in the consolidation group showed A-line disappearance,37 cases in the unconsolidation group showed A-line disappearance. There was no statistical significant differences between the two groups(P>0.05). The pulmonary ultrasound results showed 11 cases in the consolidation group and 15 cases in the unconsolidation group with pleural line abnormalities, there was no statistically significant differences between the two groups( P>0.05 ). Conclusions Ultrasound image characteristics of neonatal severe pneumonia include pulmonary consolidation and air bronchograms,A-line disappearance,pleural line abnormalities. Compared lung ultrasound and chest X-ray result,there was no difference between consolidation group and unconsolidation group. Both of the two methods can be used for evaluating the diagnosis of pneumonia.
Key words:  [Key words]The new born  Severe pneumonia  Ultrasonography