摘要
目的观察肺部超声(LUS)联合临床及实验室指标列线图模型预测肺炎肺实变患儿是否需接受支气管肺泡灌洗(BAL)的价值。方法回顾性纳入240例肺炎肺实变患儿,按7∶3随机划分训练集与验证集,并依据经48 h常规治疗后是否接受BAL划分BAL组与非BAL组。基于训练集分析临床、实验室指标及常规治疗前LUS,筛选接受BAL的独立预测因素并构建列线图模型;评估模型预测效能及其临床价值。结果发热持续时间、D-二聚体水平、LUS总分及较显著肺实变面积更大均为患儿需接受BAL的独立预测因素(P均<0.05);以之建立的列线图模型在训练集及验证集的曲线下面积分别为0.957及0.976,且决策曲线分析表明其临床净收益较高。结论LUS联合临床及实验室指标列线图模型能有效预测肺炎肺实变患儿是否需接受BAL。
Objective To explore the value of nomogram model based on lung ultrasound(LUS)combined with clinical and laboratory indicators for predicting necessity of bronchoalveolar lavage(BAL)for children with pneumonia and pulmonary consolidation.Methods Totally 240 children with pneumonia and pulmonary consolidation were retrospectively enrolled and randomly divided into training set and validation set at the ratio of 7∶3,also into BAL group and non-BAL group according to whether BAL was performed after 48 h of conventional treatment.Clinical and laboratory indicators,and LUS data before conventional treatment of children in training set were analyzed to screen independent predictors of BAL.Then a nomogram model was constructed,its predictive performance and clinical value were evaluated.Results The duration of fever,D-dimer level,total LUS score and larger area of marked pulmonary consolidation were all independent predictors of BAL(all P<0.05).The area under the curve of nomogram model established based on the above factors was 0.957 in training set and 0.976 in validation set.Decision curve analysis indicated that the model had high clinical net benefit.Conclusion Nomogram model based on LUS combined with clinical and laboratory indicators could be used to effectively predict the necessity of BAL for children with pneumonia and pulmonary consolidation.
作者
赵晶晶
李柯翰
刘亚萌
孟繁博
刘佳炜
曾成
刘岷
陈杰
王全江
韩菲燕
骈林萍
ZHAO Jingjing;LI Kehan;LIU Yameng;MENG Fanbo;LIU Jiawei;ZENG Cheng;LIU Min;CHEN Jie;WANG Quanjiang;HAN Feiyan;PIAN Linping(The First Clinical Medical College,Henan University of Chinese Medicine,Zhengzhou 450003,China;Department of Ultrasound,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450003,China;Department of Urinary Surgery,People's Hospital of Zhengzhou University,Zhengzhou 450003,China)
出处
《中国医学影像技术》
北大核心
2026年第2期214-218,共5页
Chinese Journal of Medical Imaging Technology
关键词
肺炎
超声检查
支气管肺泡灌洗
列线图
预测
pneumonia
ultrasonography
bronchoalveolar lavage
nomograms
forecasting
