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肺部超声检查在新生儿病毒性肺炎诊断及随访中的效能

Efficiency of Lung Ultrasonography in the Diagnosis and Follow-up of Viral Pneumonia in Newborn.

作者信息

Öktem Ahmet, Zenciroğlu Ayşegül, Üner Çiğdem, Aydoğan Seda, Dilli Dilek, Okumuş Nurullah

机构信息

Department of Neonatology, SBU Ankara Dr Sami Ulus Maternity Child Health and Diseases Training and Research Hospital, Ankara, Turkey.

Department of Pediatric Radiology, SBU Ankara Dr Sami Ulus Maternity Child Health and Diseases Training and Research Hospital, Ankara, Turkey.

出版信息

Am J Perinatol. 2023 Mar;40(4):432-437. doi: 10.1055/s-0041-1729880. Epub 2021 May 27.

Abstract

OBJECTIVE

Lung ultrasonography (LUS) is a useful method for diagnosis of lung diseases such as respiratory distress syndrome, transient tachypnea of the newborn, pneumonia, and pneumothorax in the neonatal period. LUS has become an important tool in the diagnosis and follow-up of lung diseases. LUS is easy to apply at the bedside and is a practical and low-cost method for diagnosing pneumonia.

STUDY DESIGN

This study was conducted in neonatal intensive care unit of Dr. Sami Ulus Obstetrics, Children's Health and Diseases Training and Research Hospital. From September 2019 to April 2020, 50 patients who were diagnosed with viral pneumonia were included in the study. Also, 24 patients with sepsis-related respiratory failure were included in the study as a control group. LUS was performed at the bedside three times, by a single expert, once each before treatment for diagnosis, on discharge, and after discharge in outpatient clinic control.

RESULTS

Before treatment, LUS findings were lung consolidation with air bronchograms (50/50), pleural line abnormalities (35/50), B-pattern (25/50), disappearance of lung sliding (21/50), lung pulse (5/50), and pleural effusion (9/50). During discharge, we found significant changes: lung consolidation with air bronchograms (6/50), pleural line abnormalities (7/50), B-pattern (12/50), and pleural effusion (1/50) ( < 0.05). Outpatient clinic control LUS findings were lung consolidation with air bronchograms (0/50), pleural line abnormalities (0/50), B-pattern (0/50), disappearance of lung sliding (0/50), and pleural effusion (0/50) ( < 0.05). Also, B-pattern image, disappearance of lung sliding, and pleural line abnormalities were higher in control group ( < 0.05).

CONCLUSION

Ultrasound gives no hazard, and the application of bedside ultrasonography is comfortable for the patients. Pneumonia is a serious infection in the neonatal period. Repeated chest radiography may be required depending on the clinical condition of the patient with pneumonia. This study focuses on adequacy of LUS in neonatal pneumonia.

KEY POINTS

· Lung ultrasound is a practical and low-cost method in diagnosing pneumonia.. · Neonatal pneumonia is a very important cause of morbidity and mortality in NICU.. · We can evaluate neonatal pneumonia with combination of clinical presentations and LUS findings..

摘要

目的

肺部超声检查(LUS)是诊断新生儿期肺部疾病的一种有用方法,如呼吸窘迫综合征、新生儿暂时性呼吸急促、肺炎和气胸。LUS已成为肺部疾病诊断和随访的重要工具。LUS易于在床边应用,是诊断肺炎的一种实用且低成本的方法。

研究设计

本研究在萨米·乌卢斯妇产、儿童健康与疾病培训及研究医院的新生儿重症监护病房进行。2019年9月至2020年4月,50例被诊断为病毒性肺炎的患者纳入研究。另外,24例脓毒症相关呼吸衰竭患者作为对照组纳入研究。由一名专家在床边进行三次LUS检查,分别在治疗前用于诊断、出院时以及出院后门诊复查时各进行一次。

结果

治疗前,LUS表现为肺实变伴支气管充气征(50/50)、胸膜线异常(35/50)、B线(25/50)、肺滑动消失(21/50)、肺搏动(5/50)和胸腔积液(9/50)。出院时,我们发现有显著变化:肺实变伴支气管充气征(6/50)、胸膜线异常(7/50)、B线(12/50)和胸腔积液(1/50)(<0.05)。门诊复查时LUS表现为肺实变伴支气管充气征(0/50)、胸膜线异常(0/50)、B线(0/50)、肺滑动消失(0/50)和胸腔积液(0/50)(<0.05)。此外,对照组的B线图像、肺滑动消失和胸膜线异常更高(<0.05)。

结论

超声检查无危害,床边超声检查的应用对患者来说很舒适。肺炎是新生儿期的一种严重感染。根据肺炎患者的临床情况,可能需要重复进行胸部X线检查。本研究关注LUS在新生儿肺炎中的充分性。

关键点

·肺部超声是诊断肺炎的一种实用且低成本的方法。·新生儿肺炎是新生儿重症监护病房发病和死亡的一个非常重要的原因。·我们可以结合临床表现和LUS表现来评估新生儿肺炎。

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