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肺部超声在1岁以下婴儿社区获得性肺炎诊断及随访中的应用

Lung ultrasound in diagnosis and follow up of community acquired pneumonia in infants younger than 1-year old.

作者信息

Omran Ahmed, Eesai Samah, Ibrahim Mostafa, El-Sharkawy Sonya

机构信息

Faculty of Medicine, Department of Pediatrics and Neonatology, Suez Canal University, Ismailia, Egypt.

Faculty of Medicine, Department of Radiodiagnosis, Suez Canal University, Ismailia, Egypt.

出版信息

Clin Respir J. 2018 Jul;12(7):2204-2211. doi: 10.1111/crj.12790. Epub 2018 Apr 17.

Abstract

BACKGROUND

Pneumonia is still a leading cause of illness and death in infants worldwide. Lung ultrasound (LUS) is emerging as an extremely valuable non-ionizing radiation diagnostic tool in diagnosis and follow up of multiple paediatric pulmonary diseases.

OBJECTIVE

To assess the applicability of LUS in diagnosis and follow up of community acquired pneumonia (CAP) in Egyptian infants younger than 1-year old.

METHODS

LUS and chest X-ray (CXR) were performed in 50 infants presented with clinical symptoms and signs suggestive of CAP within the first 6 hours of admission in our inpatient department, then follow up LUS was performed 5 days after admission.

RESULTS

This study showed that LUS was superior to CXR in initial diagnosis of CAP in infants. LUS detected pneumonia in 49 (98%) compared to 36 (72%) infants diagnosed by CXR (P < .05). On follow up, 5 days later, consolidation patch disappeared in 13 (26.5%) infants, diminished in size in 27 (55.1%) infants, remained at the same size in 2 (4.1%) infants and increased in size in 7 (14.3%) infants.

CONCLUSION

This study showed that LUS is superior to CXR in diagnosing infants with CAP who are younger than 1-year old. It also serves as a safe follow up tool and could support the decision of hospital discharge in this category of patients. Further studies with larger sample size and longer follow up duration are recommended to confirm the results of the present study.

摘要

背景

肺炎仍是全球婴儿发病和死亡的主要原因。肺部超声(LUS)正在成为一种极具价值的非电离辐射诊断工具,用于多种儿科肺部疾病的诊断和随访。

目的

评估LUS在诊断和随访埃及1岁以下婴儿社区获得性肺炎(CAP)中的适用性。

方法

对我院住院部50例入院后6小时内出现提示CAP临床症状和体征的婴儿进行LUS和胸部X线(CXR)检查,然后在入院5天后进行LUS随访。

结果

本研究表明,LUS在婴儿CAP的初始诊断中优于CXR。LUS检测出49例(98%)肺炎,而CXR诊断出36例(72%)婴儿(P < 0.05)。随访5天后,13例(26.5%)婴儿的实变灶消失,27例(55.1%)婴儿的实变灶缩小,2例(4.1%)婴儿的实变灶大小不变,7例(14.3%)婴儿的实变灶增大。

结论

本研究表明,LUS在诊断1岁以下CAP婴儿方面优于CXR。它也是一种安全的随访工具,可辅助此类患者的出院决策。建议进行更大样本量和更长随访时间的进一步研究以证实本研究结果。

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