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基于病例系列的床旁肺部超声在指导或辅助新生儿重症肺部疾病治疗中的新应用

The new application of point-of-care lung ultrasound in guiding or assisting neonatal severe lung disease treatment based on a case series.

作者信息

Liu Jing, Xia Rong-Ming, Ren Xiao-Ling, Li Jian-Jun

机构信息

Department of Neonatology and NICU, Beijing Chaoyang District Maternal and Child Healthcare Hospital, Beijing, China.

出版信息

J Matern Fetal Neonatal Med. 2020 Dec;33(23):3907-3915. doi: 10.1080/14767058.2019.1590332. Epub 2019 Mar 21.

Abstract

Lung ultrasound (LUS) has been successfully used for neonatal lung disease diagnosis, as a non-invasive, free of radiation tool, the application of point-of-care LUS (POC-LUS) to diagnose lung disease has become a new trend worldwide. This paper was to introduce the new application of LUS to guide or assist the neonatal lung diseases treatment. Based on case series of our daily routine clinical work, in combining with the latest literatures, we introducing the new using field of POC-LUS in guiding the treatment of uninflated lung disease by bronchoalveolar lavage (BAL), guiding the treatment of severe pleural effusion and pneumothorax, guide the use of and weaning from mechanical ventilation, and in assessing the efficacy of exogenous pulmonary surfactant (PS) therapy. The results of this study showed that the using rate of invasive ventilation and PS were decreased significantly, the duration of invasive ventilation was shortened significantly, the recovery of pleural effusion and pneumothorax were more quickly and safety, and finally a significantly shortened length of hospitalizations was obtained. LUS monitoring had significant effects in guiding the management of neonatal severe lung diseases, which with the worthy of extensive clinical application.

摘要

肺部超声(LUS)已成功用于新生儿肺部疾病的诊断,作为一种无创、无辐射的工具,床旁肺部超声(POC-LUS)在诊断肺部疾病中的应用已成为全球新趋势。本文旨在介绍LUS在指导或辅助新生儿肺部疾病治疗方面的新应用。基于我们日常临床工作的病例系列,并结合最新文献,我们介绍了POC-LUS在指导支气管肺泡灌洗(BAL)治疗肺不张疾病、指导治疗严重胸腔积液和气胸、指导机械通气的使用和撤机以及评估外源性肺表面活性物质(PS)治疗效果等方面的新应用领域。本研究结果表明,有创通气和PS的使用率显著降低,有创通气时间显著缩短,胸腔积液和气胸的恢复更快且更安全,最终住院时间显著缩短。LUS监测在指导新生儿重症肺部疾病的管理方面有显著效果,值得临床广泛应用。

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