肺脏超声对新生儿呼吸窘迫综合征的诊断价值及肺超声评分的评估价值分析

目的:探讨肺脏超声对新生儿呼吸窘迫综合征(NRDS)的诊断价值,并分析肺超声评分的临床应用价值。方法:本研究选择2017年5月至2018年5月于我院确诊的NRDS患儿45例作为观察组,选择同期于我院就诊的非肺病患儿45例作为对照组,所有患儿均行肺脏超声检查。分析NRDS患儿肺脏超声特征性征象,比较肺脏超声对两组患儿各种征象的检出率,分析肺脏超声对NRDS的诊断价值,比较两组肺超声评分。结果:NRDS患儿全部存在肺实质征象,超声下肺组织回声呈肝样伴支气管充气征,轻度的NRDS患儿于肺脏超声下表现为局灶性的肺实质,且支气管充气征不明显;重度的NRDS患儿于肺脏超声下表现为肺实质范围的进一步扩大,且支气管充气征随病情的加重而愈发明显。观察组肺实质、胸膜线异常、A线消失、弥漫性肺水肿、支气管充气征等征象的检出率显著高于对照组(P0.05),两组B线存在征象的检出率比较无统计学差异(P0.05)。肺实质、胸膜线异常和A线消失三种特征征象同时存在时对NRDS诊断的灵敏度和特异性均为100.00%,肺实质、胸膜线异常和支气管充气征三种特征征象同时存在时对NRDS诊断的灵敏度为80.00%,特异性为100.00%。观察组双肺、左肺、右肺、双侧肺、双肺底肺超声评分均高于对照组(P0.05)。结论:肺脏超声对NRDS的诊断价值较高,且肺超声评分可以评估NRDS患儿的病情严重程度,有助于指导患儿的治疗。

Diagnostic Value of Pulmonary Ultrasound in Neonatal Respiratory Distress Syndrome and Assessment Value Analysis of Pulmonary Ultrasound Score

ABSTRACT Objective: To explore the diagnostic value of pulmonary ultrasound in neonatal respiratory distress syndrome (NRDS), and to analyze the clinical application value of pulmonary ultrasound score. Methods: In this study, 45 children with NRDS who were di- agnosed in our hospital from May 2017 to May 2018 were selected as observation group. 45 cases of non-pulmonary children in our hos- pital during the same period were selected as control group. All children underwent pulmonary ultrasonography. The characteristics of lung ultrasonography in children with NRDS were analyzed. The detection rate of various signs of pulmonary ultrasound between the two groups were compared. The diagnostic value of pulmonary ultrasound in NRDS were analyzed. Pulmonary ultrasound scores were com- pared between the two groups. Results: The pulmonary parenchymal signs were found in all children with NRDS. Ultrasound echoes of lung tissue were hepatoid with bronchial inflation sign. The mild NRDS children showed focal parenchyma under pulmonary ultrasonog- raphy, and the bronchial aeration sign was not obviously. Severe NRDS children showed further enlargement of lung parenchyma under pulmonary ultrasonography, and bronchial inflation sign became more and more obvious with the aggravation of the disease. The detec- tion rate of pulmonary parenchyma,abnormal pleural line, disappearance of line A, diffuse pulmonary edema and bronchial inflation sign in the observation group were significantly higher than those in the control group (P<0.05). There was no significant difference in the de- tection rate of existence of B line between the two groups(P>0.05). The sensitivity and specificity of NRDS diagnosis were 100.00% when the three characteristic signs of lung parenchyma, abnormal chest model line and disappearance of A line coexisted. The sensitivity of NRDS diagnosis was 80.00% when the three characteristic signs of lung parenchyma, abnormal chest pattern and bronchial inflatabili- ty coexisted, the specificity was 100.00%. The ultrasound scores of two lungs, left lung, right lung, bilateral lung and bilateral lung base in the observation group were higher than those in the control group (P<0.05). Conclusion: Pulmonary ultrasound is of high diagnostic value for NRDS, and the pulmonary ultrasound score can evaluate the severity of NRDS in children, it is help to guide the treatment of children.