| 范伟博.床旁即时肺部超声评分指导下个体化呼吸支持对新生儿感染性肺炎预后的影响[J].中国医学影像技术,2025,41(5):806~810 |
| 床旁即时肺部超声评分指导下个体化呼吸支持对新生儿感染性肺炎预后的影响 |
| Impact of point-of-care lung ultrasound scoring-guided individualized respiratory support on prognosis of neonatal infectious pneumonia |
| 投稿时间：2024-09-30 修订日期：2025-05-08 |
| DOI：10.13929/j.issn.1003-3289.2025.05.023 |
| 中文关键词: 婴儿,新生儿 肺炎 超声检查 预后 前瞻性研究 |
| 英文关键词:infant, newborn pneumonia ultrasonography prognosis prospective studies |
| 基金项目: |
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| 中文摘要: |
| 目的 观察床旁即时肺部超声评分(POC-LUS)指导下个体化呼吸支持对新生儿感染性肺炎(NIP)预后的影响。方法 前瞻性将180例NIP患儿随机分为2组(各90例),分别给予个体化呼吸支持(干预组)或常规治疗(对照组),并基于POC-LUS、临床症状及血气分析加以调整;6个月后随访并比较2组肺功能。结果 POC-LUS的组间效应、时间效应及交互效应均有统计学意义(P均＜0.05)。干预组有创转无创呼吸支持及经鼻持续气道正压通气转高流量氧疗时间均显著短于对照组(P均＜0.05)。相比对照组,干预组达撤机标准时间更短、治疗后72 h氧合指数及PaO2提升更快而住院时间有所缩短(P均＜0.05)。随访显示干预组潮气量(VT)及潮气呼气流速峰值(PTEF)均高于对照组(P均＜0.05)。结论 POC-LUS指导下个体化呼吸支持策略可改善NIP患儿预后。 |
| 英文摘要: |
| Objective To observe the impact of point-of-care lung ultrasound scoring (POC-LUS)-guided individualized respiratory support on prognosis of neonatal infectious pneumonia (NIP). Methods Totally 180 infants with NIP were prospectively enrolled and randomly assigned to intervention group or control group (each n=90) and receiving individualized respiratory support based on POC-LUS assessments or conventional treatment, respectively, and the respiratory support strategies were adjusted according to POC-LUS scores, clinical symptoms and blood gas analysis, respectively. Pulmonary function was assessed 6 months after discharge and compared between groups. Results Significant differences of POC-LUS scores were noticed on group, time and interaction effects (all P＜0.05). The duration of invasive to non-invasive support, and of nasal continuous positive airway pressure (NCPAP) to high-flow oxygen in intervention group were both significantly shorter than those in control group (both P＜0.05). Compared with control group, NIP neonates in intervention group achieved criteria for weaning from respiratory support more rapidly, with higher oxygenation index and PaO2 levels 72 h after treatment, also had shorter length of hospital stay (all P＜0.05). Six months after discharge, tidal volume (VT) and peak tidal expiratory flow (PTEF) in intervention group were both significantly higher those in control group (both P＜0.05). Conclusion POC-LUS-guided individualized respiratory support could improve prognosis of infants with NIP. |
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