超声波和临床方法测定新生儿肝脏大小的对比研究

Sonographic and clinical assessment of liver size in neonates

目的为评价临床方法测定肝脏大小的可靠性，建立新生儿肝脏大小正常参考值范围和建立估价新生儿肝脏大小的回归方程。方法应用超声波和临床方法前瞻性、双盲、对比研究连续出生的１～３日龄的１８４例新生儿肝脏大小。结果超声波与叩诊、叩诊／触诊法在右锁骨中线上测得肝全长及触诊右锁骨中线肋缘下（ＲＣＭ）肝脏大小有很好的相关性（ｒ＝０７３，０７９，０８７，Ｐ＜００１）。新生儿肝脏全长及ＲＣＭ大小（ｃｍ）超声波是（６０３±０３５）ｃｍ，（２１０±０３８）ｃｍ；叩诊法（５７１±０５３）ｃｍ，（２０７±０４５）ｃｍ；叩诊／触诊法（５９７±０５０）ｃｍ，（２３４±０３９）ｃｍ。新生儿肝脏大小回归方程＝３８０＋０２５体重（ｋｇ）＋００４孕龄（周）。结论临床方法测定肝脏大小可靠。

Objective To evaluate the reliability of clinical methods for estimation of liver size and to establish the range of normal value and the regression equation of liver size in neonates.Methods We measured the liver size in 184 cases by sonographic and clinical method with a double-blind design at 1～3 days of life.Results The values of the liver span and the distance of the liver edge below the right costal margin at midclavicular line measured by clinical percussion and percussion /palpation methods correlated well with those measured by sonography( r =0 73, 0 79 and 0 87, all P <0 01, respectively) for the entire sample.The liver span and the distance of the liver edge below the right costal margin were (6 03±0 35)cm and (2 10±0 38)cm by sonography.(5 71±0 53)cm and (2 07±0 45)cm by percussion.(5 97±0 50)cm and (2 34±0 39)cm by percussion/palation.The regression equation for the liver size in neonates was:the liver span=3 80+0 25 body weight(kg)+0 04 gestational age(weeks)cm.Conclusion The clinical methods for estimation of the liver size are reliable and practical.