薛静,张周龙,陈胜江,吕海霞,孙继锋.肺超声评分评估新生儿呼吸窘迫综合征[J].中国医学影像技术,2022,38(7):1013~1016
肺超声评分评估新生儿呼吸窘迫综合征
Pulmonary ultrasound score for evaluating neonatal respiratory distress syndrome
投稿时间:2021-11-19  修订日期:2022-02-10
DOI:10.13929/j.issn.1003-3289.2022.07.011
中文关键词:  呼吸窘迫综合征,新生儿  超声检查
英文关键词:respiratory distress syndrome,newborn  ultrasonography
基金项目:河南省医学科技攻关计划(联合共建)项目(LHGJ20190563)。
作者单位E-mail
薛静 河南科技大学临床医学院 河南科技大学第一附属医院超声科, 河南 洛阳 471000 ixuejing2021@163.com 
张周龙 河南科技大学临床医学院 河南科技大学第一附属医院超声科, 河南 洛阳 471000  
陈胜江 河南科技大学临床医学院 河南科技大学第一附属医院超声科, 河南 洛阳 471000  
吕海霞 河南科技大学临床医学院 河南科技大学第一附属医院超声科, 河南 洛阳 471000  
孙继锋 河南科技大学临床医学院影像科, 河南 洛阳 471000  
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中文摘要:
       目的 观察肺超声评分(LUS)用于评估新生儿呼吸窘迫综合征(NRDS)的价值。方法 回顾性分析148例NRDS患儿(NRDS组)及60名非肺病新生儿(对照组)的肺超声声像图,比较组间肺部各分区及总LUS的差异,观察总LUS与NRDS患儿临床资料及相关参数的关系,评价总LUS判断临床分度的效能及总LUS、X线分级判断NRDS患儿是否需要接受有创辅助通气的效能并比较其差异。结果 NRDS组患儿肺部A线消失,B线呈散在或融合分布;对照组新生儿胸膜线规则、光滑,双肺均见A线,仅见极少量B线。NRDS组各分区及总LUS均高于对照组(P均<0.05)。NRDS组患儿总LUS与临床分度、X线分级、辅助通气模式分级及使用呼吸机天数均呈正相关(r=0.67、0.56、0.60、0.63,P均<0.05),与呼吸机参数呼气末正压、吸气峰压及吸入氧浓度均呈正相关(r=0.41、0.65、0.47,P均<0.05)。总LUS评估轻、中及重度NRDS的曲线下面积(AUC)分别为0.845、0.862、0.905;以总LUS 22.5分及X线分级2级判断NRDS患儿需要接受有创辅助通气的AUC分别为0.862及0.796,总LUS评估效能优于X线分级(P<0.001)。结论 LUS可用于评估NRDS患儿病情严重程度并判断其预后。
英文摘要:
      Objective To observe the value of pulmonary ultrasound score (LUS) for evaluating neonatal respiratory distress syndrome (NRDS). Methods Lung ultrasonograms of 148 cases with NRDS (NRDS group) and 60 newborns without pulmonary lesions (control group) were retrospectively reviewed, and lung division and total LUS were compared between groups. The relationships of total LUS and clinical data and related parameters of newborns with NRDS were analyzed. The efficacy of total LUS for judging clinical scores, of total LUS and X-ray grade for assessing whether newborns with NRDS need to receive invasive assisted ventilation were evaluated and compared. Results In NRDS group, B-lines were scattered or fused. The pleural line of the control group was regularly smooth, A-lines were seen in both lungs, while only a few B-line were detected. The division and total LUS in NRDS group were higher than those in control group (all P<0.05). Total LUS in NRDS group was positively correlated with clinical scores, X-ray grade, auxiliary ventilation mode grade and ventilator days (r=0.67, 0.56, 0.60, 0.63, all P<0.05), also positively correlated with ventilator parameters, including positive end-expiratory pressure, peak inspiratory pressure and fraction of inspire O2 (r=0.41, 0.65, 0.47, all P<0.05). The areas under the curves (AUC) of mild, moderate and severe NRDS assessed with total LUS was 0.845, 0.862, 0.905, respectively. Based on total LUS of 22.5 points and the X-ray grade of 2nd, the AUC of NRDS newborns needed invasive auxiliary ventilation was 0.862 and 0.796 respectively, and the evaluating efficiency of total LUS was better than that of X-ray grade (P<0.001). Conclusion LUS could be used to evaluate the severity and prognosis of NRDS.
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