Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Istituto di Microbiologia, Università Cattolica del Sacro Cuore, Rome, Italy.
Pediatr Radiol. 2020 Oct;50(11):1560-1569. doi: 10.1007/s00247-020-04750-w. Epub 2020 Aug 21.
Lung ultrasound (US) in the evaluation of suspected pediatric pneumonia is increasingly used and has a recognized role in evaluating pleural effusions, although there are no detailed studies specifically addressing its use in the pediatric population.
To define lung US findings of severe pediatric community-acquired pneumonia that required surgical procedures during admission.
Our prospective case-control study compared lung US findings in patients ages 1 month to 17 years admitted with community-acquired pneumonia that required surgical procedures from findings those who did not. Lung US was performed at admission and always before surgical procedures. Medical treatment, laboratory and microbiological findings, chest X-ray, computed tomography scan and surgical procedures are described.
One hundred twenty-one children with community-acquired pneumonia were included; of these, 23 underwent surgical intervention. Compared with the control group, children requiring a surgical procedure had a significantly higher rate of large consolidations (52.2%; 95% confidence interval [CI]: 30.6% to 73.2%), larger and complicated pleural effusions (100%; 95% CI: 85.2% to 100%), and both liquid and air bronchograms (73.9%; 95% CI: 51.6% to 89.8%).
Larger consolidations, larger and more complicated pleural effusions, and liquid and air bronchograms were associated with surgical treatment.
肺部超声（US）在疑似小儿肺炎的评估中越来越多地被使用，并且在评估胸腔积液方面具有公认的作用，尽管没有专门针对儿科人群的详细研究。
定义需要在入院期间进行手术的严重小儿社区获得性肺炎的肺部 US 表现。
我们的前瞻性病例对照研究比较了入院时患有需要手术治疗的社区获得性肺炎的 1 个月至 17 岁患者的肺部 US 表现与未接受手术的患者的肺部 US 表现。肺部 US 在入院时进行，并且总是在手术前进行。描述了医疗治疗、实验室和微生物学发现、胸部 X 射线、计算机断层扫描和手术过程。
共纳入 121 例患有社区获得性肺炎的儿童；其中 23 例接受了手术干预。与对照组相比，需要手术的患儿大实变的发生率明显更高（52.2%；95%置信区间 [CI]：30.6%至 73.2%），胸腔积液更大且更复杂（100%；95%CI：85.2%至 100%），以及液性和气性支气管征（73.9%；95%CI：51.6%至 89.8%）。
更大的实变、更大且更复杂的胸腔积液以及液性和气性支气管征与手术治疗相关。
