摘要
目的探讨胎粪吸入综合征（MAS）的超声影像学特点及肺脏超声对MAS的诊断价值。方法选取2014年8月至2015年10月根据病史、临床表现和胸部X线检查诊断为MAS的67患儿为研究对象，以100例无肺部病变的新生儿为对照，归纳和总结MAS的超声影像学特点。在安静状态下，患儿取仰卧、侧卧或俯卧位，以腋前线、腋后线为界，将每侧肺脏分成前、侧、后3个区域，探头与肋骨垂直或平行，分别对双侧肺脏的每个区域进行扫查。结果本组MAS患儿的肺超声主要表现：（1）肺实变伴支气管充气征，见于所有患儿。通常重度患儿肺实变范围较大、边界不规则，轻度患儿则为局灶性小范围实变。（2）胸膜线异常和A．线消失，见于所有患儿。（3）肺不张，见于重度MAS患儿，本组12例（17．9％），严重大面积肺不张时还可见肺搏动。（4）胸腔积液，轻度或重度患儿均可见，本组9例（13．4％）。（5）所有患儿在非实变区呈肺间质综合征改变或表现为B-线。结论MAS患儿具有典型的肺部超声影像学改变。由于准确、可靠、费用低、操作方便、无射线损伤，以及便于动态观察和及时了解病情变化，可常规用于MAS的诊断。
Objective To investigate the diagnostic value of lung ultrasonography for meconium aspiration syndrome （MAS）. Methods From August 2014 to October 2015, a total of 67 cases of MAS patients were included in this study based on the medical history,typical clinical symptoms and chest X ray findings. The control group comprised 100 neonates without pulmonary disease. In a resting state, each patient was placed in a supine, lateral recumbent, or prone position. Using the anterior and posterior axillary lines as boundaries, each side of the lung was divided into 3 regions ： anterior,lateral and posterior. The probe was held perpendicular or parallel to the ribs, and each region of both sides of the lung was scanned. Results In this study, the main lung uhrasonographic findings in MAS patients were as follows ： （ 1 ） Lung consolidation with air bronchograms, which was found in all patients. Generally, the large area of lung consolidation with irregular margins was seen in severe MAS patients while the small area of lung consolidation was seen in mild patients. （2） Pleural line anomalies and the disappearance of the A - lines, which were found in all patients. （3） Atelectasis, which was found in 12 severe cases（ 17.9% ） ,with severe massive atelectasis and visible lung pulse. （4） Pleural effusion, which was found in 9 cases （ 13.4% ） including mild or severe patients. （5） Alveolar - interstitial syndrome （AIS） or B -line in the non -consolidation area was found in all patients. Conclusions There were specific imaging findings in lung ultrasound in MAS patients. Lung uhrasonography can be used for the routine diagnosis of MAS because of its accuracy, reliability, low - cost and simplicity, no risk of radiation damage as well as it is convenience to observe and understand the dynamic changes of the patients＇ condition timely.
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2016年第16期1227-1230,共4页
Chinese Journal of Applied Clinical Pediatrics
基金
吴阶平医学基金会临床科研专项资助基金（320.6750.15072）
关键词
肺脏超声
胎粪吸入综合征
婴儿
新生
Lung uhrasonography
Meconium aspiration syndrome
Infant, newborn
