肺部超声新评分法在新生儿呼吸窘迫综合征病情评价及治疗中的应用效果

Effect of a new lung ultrasound scoring method in evaluation of disease condition of neonatal respiratory distress syndrome and its application in treatment

  • 摘要:
    目的 观察肺部超声新评分法(LUS)对新生儿呼吸窘迫综合征(NRDS)病情的评价效果及其在肺泡表面活性物质(PS)治疗中的应用效果。
    方法 回顾性分析91例NRDS患儿的临床资料,所有NRDS患儿均行PS治疗,另选取同期行健康体检的70例患儿为健康对照组。依据临床表现及出生6 h内的X线检查结果,将91例NRDS组的患儿分为轻症组(39例)与重症组(52例)。比较NRDS组与健康对照组、胎龄 < 30周与胎龄≥30周患儿以及轻症组与重症组患儿的肺部超声表现。比较轻症组和重症组PS治疗不同时点LUS评分。
    结果 NRDS组患儿肺实变、支气管充气征、融合B线、肺泡间质综合征、胸膜线异常、胸腔积液检出率均高于健康对照组,差异有统计学意义(P < 0.05)。胎龄 < 30周患儿肺泡间质综合征检出率低于胎龄≥30周患儿,差异有统计学意义(P < 0.05)。重症组支气管充气征、融合B线、胸膜线异常、胸腔积液检出率均高于轻症组,差异有统计学意义(P < 0.05)。治疗前,轻症组LUS评分低于重症组,差异有统计学意义(P < 0.05);治疗后12、24 h,2组患儿LUS评分均较治疗前下降,且轻症组低于重症组,差异有统计学意义(P < 0.05)。
    结论 LUS在NRDS的病情评价中具有较为理想的价值,能够作为PS治疗NRDS的有效评估手段。

     

    Abstract:
    Objective To observe effect of a new lung ultrasound scoring method in evaluation of disease condition of neonatal respiratory distress syndrome (NRDS) and its application in treatment of pulmonary surfactant (PS).
    Methods The clinical data of 91 children with NRDS were retrospectively analyzed, all children with NRDS were treated with PS. A total of 70 children who underwent physical examinations during the same period were selected as healthy control group. According to the clinical manifestations and X-ray examination results within 6 hours after birth, 91 children in the NRDS group were further divided into mild group (39 cases) and severe group (52 cases). The pulmonary ultrasound manifestations were compared between NRDS group and healthy control group, children with gestational age < 30 weeks and ≥ 30 weeks, and mild group and severe group. The LUS scores at different time points were compared between the mild and severe groups treated by PS.
    Results The detection rates of lung consolidation, air bronchogram, B-line fusion, alveolar interstitial syndrome, pleural line abnormality and pleural effusion in the NRDS group were higher than those in healthy control group (P < 0.05). The detection rate of alveolar interstitial syndrome in children with gestational age < 30 weeks was lower than that in children with gestational age ≥ 30 weeks (P < 0.05). The detection rates of air bronchogram, B-line fusion, pleural line abnormality and pleural effusion in the severe group were higher than those in the mild group (P < 0.05). Before treatment, LUS score of the mild group was lower than that of the severe group (P < 0.05). At 12 and 24 h after treatment, the LUS scores of the two groups were decreased compared with those before treatment, and the LUS scores of the mild group were lower than those of the severe group (P < 0.05).
    Conclusion LUS has an ideal value in the evaluation of NRDS, and can be used as an effective evaluation method for PS treatment of NRD.

     

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