超声在高原地区新生儿肺炎诊断中的应用价值
The Role of Lung Ultrasonography in the Diagnosis of Neonatal Pneumonia in Plateau Area
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摘要: 目的 研究肺超声 (lung ultrasonography, LUS) 在高原地区新生儿肺炎中的诊断价值.方法 对2015年6月至2017年12月临床确诊的200例新生儿肺炎住院患儿及200例黄疸非肺炎对照组患儿进行床旁LUS检查, 将双侧前后胸壁以胸骨旁线、腋前线、腋后线连线划分为6个区, 进行横向、纵向系统扫查.观察胸膜线、A线、B线、肺实变及有无胸腔积液等.结果 200例新生儿肺炎床旁LUS检查阳性率100%, 主要超声表现为69例有肺实变 (34.5%) , 200例有多区域多条B线 (100%) , 胸膜线异常22例 (11%) , 局限性胸腔积液13例 (6.5%) .对照组169例患儿超声表现为A线 (84.5%) , 31例表现为B线 (15.5%) .2组比较差异有统计学意义 (χ2=13.65 P<0.05) .结论 高原地区新生儿肺炎的声像图表现包括B线、肺实变、胸膜线异常和局限性胸腔积液等, 其中以B线、肺实变出现率最高, 是诊断新生儿肺炎的可靠征象.Abstract: Objective To evaluate the role of lung ultrasonography (LUS) in the diagnosis of neonatal pneumonia in plateau area. Me thods A total number of 200 cases of clinically diagnosed neonatal pneumonia were examined by bedside lung ultrasound from June 2015 to December 2017 and 200 cases of icterus neonatorum were selected as the control group. The chest wall was divided into 6 regions by side-sternal line, anterior axillary line and posterior axillary line. Each region was scanned by ultrasound horizontally and longitudinally. Pleural line, A-line, B-line, pulmonary consolidation and pleural effusion were checked. Re s ults The positive rate of bedside lung ultrasound examination in 200 cases of neonatal pneumonia was 100%. The main ultrasonographic manifestations of neonatal pneumonia were as follows: pulmonary consolidation (69/200 cases, 34.5%) , multiple B-lines in a multi regions (200/200 cases, 100%) , pleural line abnormalities (22/200 cases, 11%) , and localized pleural effusion (13/200 cases, 6.5%) . Only A-line (169/200 cases, 84.5%) and B-line (31/200 cases, 15.5%) were observed in the control group. There were statistical differences between the two groups (χ2= 13.65, P<0.05) . Conclus ion The main ultrasonographic manifestations of neonatal pneumonia in plateau area included B-lines, pulmonary consolidation, pleural line abnormalities and localized pleural effusion. As the highest occurrence rate of B-line and pulmonary consolidation, they can be used as a reliable sign for diagnosis of neonatal pneumonia.
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Key words:
- Lung ultrasonography /
- Infant /
- Newborn /
- Pneumonia
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