摘要
目的探讨肺超声评分评估新生儿呼吸窘迫综合征(NRDS)肺病变及预后的可行性和临床价值。方法选取我院拟诊为NRDS的新生儿120例,对经临床确诊患儿实施机械通气和肺表面活性物质治疗,治疗前后均行肺部超声检查且对肺部病变超声检查结果进行评分,同时与胸部X线检查结果进行比较。结果120例患儿中90例经临床确诊为NRDS,其余30例为暂时性呼吸增快症。以临床综合诊断结果为标准,超声诊断NRDS的敏感性、特异性、准确率分别为95.56%、96.67%、95.83%,均高于X线(86.67%、80.00%、85.00%),差异均有统计学意义(均P<0.05);超声与临床诊断的一致性良好(Kappa=0.789)。NRDS新生儿治疗前的肺超声评分均低于暂时性呼吸增快症新生儿,差异有统计学意义(P<0.05);NRDS新生儿治疗后的肺超声评分较治疗前增高,差异有统计学意义(P<0.05)。结论应用肺部超声可较敏感准确地检出NRDS,肺超声评分可对新生儿肺部病变程度予以评估,有较好的临床应用价值。
Objective To evaluate the feasibility and clinical value of pulmonary lesions and prognosis in neonatal respiratory distress syndrome(NRDS)with pulmonary ultrasound score.Methods A total of 120 neonates with NRDS were selected and treated with mechanical ventilation and pulmonary surfactant.Before and after treatment,lung ultrasound examination was performed and the results of ultrasonic examination of lung lesions were scored.At the same time,compared with the results of chest X-ray examination.Results Ninety of the 120 children were clinically diagnosed as NRDS,and the remaining 30 were temporary respiratory enhancement.Taken the clinical comprehensive diagnosis results as standard,the sensitivity,specificity and accuracy of ultrasound in the diagnosis of NRDS were 95.56%,96.67%,and 95.83%,respectively which were higher than those of X-ray(86.67%,80.00%,85.00%),the differences were statistically significant(all P<0.05).The consistency of ultrasound and clinical diagnosis was good(Kappa=0.789).The pulmonary ultrasound scores of neonates before treatment was lower than that of temporary respiratory enhancement neonates,the differences was statistically significant(P<0.05),while the pulmonary ultrasound scores of NRDS neonates after treatment was higher than that of before treatment,the differences was statistically significant(P<0.05).Conclusion Lung ultrasound can detect NRDS more sensitively and accurately,and the lung ultrasound scores can be used to evaluate the degree and prognosis of pulmonary lesions in neonates,which has a good clinical value.
作者
程远
CHENG Yuan(Department of Ultrasound,Central Hospital,Panyu District,Guangzhou 511400,China)
出处
《临床超声医学杂志》
CSCD
2020年第5期382-384,共3页
Journal of Clinical Ultrasound in Medicine
关键词
超声检查
肺
肺超声评分
新生儿
呼吸窘迫综合征
Ultrasonography,lung
Lung ultrasound score
Neonatal
Respiratory distress syndrome
