目的：探讨双肺12区肺超声评分法在评价新生儿呼吸窘迫综合征（Neonatal respiratory distress syndrome，NRDS）严重程度中的价值。方法：通过高频超声对临床及X线确诊的60例NRDS患儿进行肺部扫查，分析肺超声影像学特点，探讨双肺12区超声B-线评分、经腹超声分级与X线分级之间的相关性。结果：双肺12区超声评分与X线分级呈显著负相关（r=-0.771，P<0.01），经腹肺超声分级与X线分级呈正相关（r=0.636，P<0.01）。X线分级多组间超声评分差异有统计学意义（F=30.34，P<0.001），Ⅰ级与Ⅱ级、Ⅱ级与Ⅲ级、Ⅲ级与Ⅳ级间超声评分差异均有统计学意义（P<0.05）。结论：双肺12区超声评分法优于经腹超声分级，可作为NRDS患儿早期诊断、病情判断和预后观察的一种有效方法，与X线相比更直观、快速、无辐射。
Abstract
Objective: To investigate the diagnostic value of lung ultrasonography scores for evaluation of the state of neonatal respiratory distress syndrome(NRDS). Methods: Analysis the characteristics of ultrasonic images and chest radiographs in 60 NRDS. The relationship between the stages of NRDS assessed by ultrasonography scores and chest radiographs were analyzed. Results: There was a significant correlation between the ultrasonography score and the chest radiographs(r=-0.771, P<0.01). The grade of transabdominal lung ultrasound was positively correlated with the grade of X-ray(r=0.636, P<0.01). Ultrasonography scores were significant differences in X-ray grade(F=30.34, P<0.001). Conclusion: The ultrasonography score can be used as an effective method for early diagnosis, condition assessment and prognosis of NRDS, and it is more direct, fast and without radiation compared with X-ray.
关键词
呼吸窘迫综合征 /
新生儿；超声检查
Key words
Respiratory distress syndrome, newborn /
Ultrasonography
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参考文献
[1]代苗英，李少兵，胡金绘，等. 不同胎龄新生儿呼吸窘迫综合征高危因素及临床分析[J]. 临床儿科杂志，2014，32（7）：644-648.
[2]Zhou B, Zhai JF, Jiang HX, et al. Usefulness of DuoPAP in the treatment of very low birth weight preterm infants with neonatal respiratory distress syndrome[J]. Eur Rev Med Pharmacol Sci, 2015, 19(4): 573-577.
[3]邵肖梅，叶鸿瑁，邱小汕. 实用新生儿学[M]. 4版. 北京：人民卫生出版社，2012：395-396.
[4]Bober K, Swietlinski J. Diagnostic utility of ultrasonography for respiratory distress syndrome in neonates[J]. Med Sci Monit, 2006, 12(10): 440-446.
[5]Ahuja CK, Saxena AK, Sodhi KS, et al. Role of transabdominal ultrasound of lung bases and follow-up in premature neonates with respiratory distress soon after birth[J]. Indian J Radiol Imaging, 2012, 22(4): 279-283.
[6]Bouhemad B, Brisson H, Le-Guen M, et al. Bedside ultrasound assessment of positive end-expiratory pressure-induced lung recruitment[J]. Am J Respir Crit Care Med, 2011, 183(3): 341-347.
[7]徐赛英. 实用儿科放射诊断学[M]. 北京出版社，1999：252-257.
[8]Hasan AA, Makhlouf HA. B-lines: Transthoracic chest ultrasound signs useful in assessment of interstitial lung diseases[J]. Ann Thorac Med, 2014, 9(2): 99-103.
[9]闫丹丹，张丹，李燕东，等. 家兔胸部弥漫性彗星尾征模型的建立[J]. 中华临床医师杂志：电子版，2014，8（24）：4440-4443.
[10]刘敬. 肺脏超声诊断新生儿呼吸窘迫综合征[J]. 中华实用儿科临床杂志，2014，29（18）：1438-1440.
[11]刘敬，曹海英，刘颖. 肺脏超声对新生儿呼吸窘迫综合征的诊断价值[J]. 中华儿科杂志，2013，51（3）：205-210.
[12]张丹，李唯，孟焱，等. 超声诊断急性肺损伤及急性呼吸窘迫综合征的价值[J]. 中国医学影像学杂志，2008，16（3）：173-175.
基金
湖南省社发领域科技支撑计划2015SK2019
