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[床旁肺部超声在新生儿肺炎诊断中的价值]

[Value of bedside lung ultrasound in the diagnosis of neonatal pneumonia].

作者信息

Xiao Tian-Tian, Jin Mei, Ju Rong, Yang Sheng, Gao Shu-Qiang, Jiang Yan, Zhang Xiao-Long

机构信息

Neonatal Intensive Care Unit, Chengdu Women and Children's Central Hospital, Chengdu 610000, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2018 Jun;20(6):444-448. doi: 10.7499/j.issn.1008-8830.2018.06.003.

Abstract

OBJECTIVE

To study the value of bedside lung ultrasound in the diagnosis of neonatal pneumonia.

METHODS

A total of 49 neonates who were admitted to the Neonatal Intensive Care Unit of Chengdu Women and Children's Central Hospital in March 2017 with respiratory symptoms as the chief complaint were enrolled. Bedside lung ultrasound was performed within 24 hours after admission. A retrospective analysis was performed for their clinical data and lung ultrasound findings. The value of bedside lung ultrasound in the diagnosis of neonatal pneumonia was evaluated.

RESULTS

According to the gold standard for the diagnosis of neonatal pneumonia, of all 49 neonates, 44 were diagnosed with pneumonia. According to the criteria for the diagnosis of neonatal pneumonia based on lung ultrasound findings, 38 neonates were diagnosed with pneumonia. In the neonates with respiratory symptoms, lung ultrasound had a sensitivity of 86%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 45% in the diagnosis of neonatal pneumonia. Among the 44 cases of neonatal pneumonia diagnosed by the gold standard, the lung ultrasonic images showed B-lines in all 44 neonates (100%), 75% had pleural line abnormalities, 36% had patchy or local hypoechoic area in the lung, 27% had alveolar-interstitial syndrome, and 20% had air bronchogram.

CONCLUSIONS

As a new diagnostic technique in clinical practice, bedside lung ultrasound has a high sensitivity and specificity for the diagnosis of neonatal pneumonia and can thus be used as a tool for the diagnosis of this disease.

摘要

目的

探讨床旁肺部超声在新生儿肺炎诊断中的价值。

方法

选取2017年3月入住成都市妇女儿童中心医院新生儿重症监护病房、以呼吸道症状为主诉的49例新生儿。入院后24小时内进行床旁肺部超声检查。对其临床资料及肺部超声检查结果进行回顾性分析。评估床旁肺部超声在新生儿肺炎诊断中的价值。

结果

根据新生儿肺炎诊断的金标准,49例新生儿中,44例被诊断为肺炎。根据基于肺部超声检查结果的新生儿肺炎诊断标准,38例新生儿被诊断为肺炎。在有呼吸道症状的新生儿中,肺部超声诊断新生儿肺炎的敏感度为86%,特异度为100%,阳性预测值为100%,阴性预测值为45%。在金标准诊断的44例新生儿肺炎病例中,肺部超声图像显示44例均有B线(100%),75%有胸膜线异常,36%肺部有斑片状或局部低回声区,27%有肺泡-间质综合征,20%有空气支气管征。

结论

床旁肺部超声作为临床实践中的一种新诊断技术,对新生儿肺炎的诊断具有较高的敏感度和特异度,可作为诊断该疾病的工具。

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