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新生儿科医生实施的床旁腹部超声检查:我们目前了解到了什么?

Neonatologist-performed point-of-care abdominal ultrasound: What have we learned so far?

作者信息

Priyadarshi Archana, Rogerson Sheryl, Cruzado Rommel, Crow Amanda, Hinder Murray, Popat Himanshu, Soundappan Soundappan S V, Badawi Nadia, Tracy Mark

机构信息

Westmead Hospital Neonatal Intensive Care Unit, Sydney, NSW, Australia.

Grace Centre for Newborn Intensive Care at The Children`s Hospital Westmead, Sydney, NSW, Australia.

出版信息

Front Pediatr. 2023 Apr 28;11:1173311. doi: 10.3389/fped.2023.1173311. eCollection 2023.

Abstract

This review describes the sonographic appearances of the neonatal bowel in Necrotising enterocolitis. It compares these findings to those seen in midgut-Volvulus, obstructive intestinal conditions such as milk-curd obstruction, and slow gut motility in preterm infants on continuous positive airway pressure (CPAP)-CPAP belly syndrome. Point-of-care bowel ultrasound is also helpful in ruling out severe and active intestinal conditions, reassuring clinicians when the diagnosis is unclear in a non-specific clinical presentation where NEC cannot be excluded. As NEC is a severe disease, it is often over-diagnosed, mainly due to a lack of reliable biomarkers and clinical presentation similar to sepsis in neonates. Thus, the assessment of the bowel in real-time would allow clinicians to determine the timing of re-initiation of feeds and would also be reassuring based on specific typical bowel characteristics visualised on the ultrasound.

摘要

本综述描述了坏死性小肠结肠炎中新生儿肠道的超声表现。将这些发现与中肠扭转、诸如凝乳性肠梗阻等梗阻性肠道疾病以及接受持续气道正压通气(CPAP)的早产儿肠道蠕动缓慢(CPAP腹部综合征)中的表现进行了比较。床旁肠道超声对于排除严重和活跃的肠道疾病也有帮助,当在无法排除坏死性小肠结肠炎的非特异性临床表现中诊断不明确时,可使临床医生安心。由于坏死性小肠结肠炎是一种严重疾病,它常常被过度诊断,主要原因是缺乏可靠的生物标志物以及其临床表现与新生儿败血症相似。因此,实时评估肠道将使临床医生能够确定重新开始喂养的时机,并且基于超声所见的特定典型肠道特征也能让人安心。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91d0/10175674/435d9ee2dc08/fped-11-1173311-g001.jpg

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