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肺部超声在新生儿呼吸窘迫综合征诊断中的作用。

The role of lung ultrasound in diagnosis of respiratory distress syndrome in newborn infants.

作者信息

Liu Jing, Cao Hai-Ying, Wang Hua-Wei, Kong Xiang-Yong

机构信息

Department of Neonatology & NICU, Bayi Children's Hospital Affiliated to Beijing Military General Hospital.

Department of Ultrasonography, GE Healthcare of USA , Beijing, China.

出版信息

Iran J Pediatr. 2014 Apr;24(2):147-54.

Abstract

OBJECTIVE

The aim of this study was to evaluate the value of lung ultrasound in the diagnosis of respiratory distress syndrome (RDS) in newborn infants.

METHODS

From March 2012 to May 2013, 100 newborn infants were divided into two groups: RDS group (50 cases) and control group (50 cases). According to the findings of chest x-ray, there were 10 cases of grade II RDS, 15 grade III cases, and 25 grade IV cases in RDS group. Lung ultrasound was performed at bedside by a single expert. The ultrasound indexes observed in this study included pleural line, A-line, B-line, lung consolidation, air bronchograms, bilateral white lung, interstitial syndrome, lung sliding, lung pulse etc.

FINDINGS

In all of the infants with RDS, lung ultrasound consistently showed generalized consolidation with air bronchograms, bilateral white lung or interstitial syndrome, pleural line abnormalities, A-line disappearance, pleural effusion, lung pulse, etc. The simultaneous demonstration of lung consolidation, pleural line abnormalities and bilateral white lung, or lung consolidation, pleural line abnormalities and A-line disappearance co-exists with a sensitivity and specificity of 100% for the diagnosis of neonatal RDS.

CONCLUSION

This study indicates that using an ultrasound to diagnose neonatal RDS is accurate and reliable tool. A lung ultrasound has many advantages over other techniques. Ultrasound is non-ionizing, low-cost, easy to operate, and can be performed at bedside, making this technique ideal for use in NICU.

摘要

目的

本研究旨在评估肺部超声在新生儿呼吸窘迫综合征(RDS)诊断中的价值。

方法

2012年3月至2013年5月,将100例新生儿分为两组:RDS组(50例)和对照组(50例)。根据胸部X线检查结果,RDS组中II级RDS有10例,III级15例,IV级25例。由一名专家在床边进行肺部超声检查。本研究观察的超声指标包括胸膜线、A线、B线、肺实变、空气支气管征、双侧白肺、间质综合征、肺滑动、肺搏动等。

结果

在所有RDS患儿中,肺部超声始终显示广泛性实变伴空气支气管征、双侧白肺或间质综合征、胸膜线异常、A线消失、胸腔积液、肺搏动等。肺实变、胸膜线异常和双侧白肺同时出现,或肺实变、胸膜线异常和A线消失同时存在,对新生儿RDS诊断的敏感性和特异性均为100%。

结论

本研究表明,超声是诊断新生儿RDS的准确可靠工具。肺部超声相对于其他技术有许多优势。超声是非电离的、低成本、易于操作,且可在床边进行,使其成为新生儿重症监护病房(NICU)理想的检查技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b084/4268833/182a96832a79/IJPD-24-147-g001.jpg

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