肺脏超声在新生儿感染性肺炎诊断中的临床价值

Clinical value of lung ultrasound in the diagnosis of neonatal infectious pneumonia

目的探讨肺脏超声(LUS)在新生儿感染性肺炎(IPN)中的临床应用价值。方法回顾性分析2016年5月至2017年10月住院的80例IPN患儿的LUS及胸部X线(CXR)检查结果,比较两者的检出率,并对所有LUS诊断为IPN的患儿进行LUS随访,观察疗效。结果 80例IPN患儿中LUS诊断76例,CXR诊断65例,其中4例CXR表现为阳性而LUS表现为阴性,15例CXR表现为阴性而LUS表现为阳性。76例患儿均行LUS随访观察,至10~14 d时40例患儿的声像图表现为正常,15例患儿表现为实变区消失,但仍可见散在或较致密的B-线;13例患儿的实变区域较入院时明显减小,表现为胸膜下的小片状实变,8例患儿的实变区较入院时变化不明显且其中4例伴有肺搏动。结论肺脏超声对IPN的诊断具有很高的临床价值,能动态观察病情的变化,可作为IPN的首选影像学检查诊断方法。

Objective To discuss the clinical value of lung ultrasound（LUS） in the diagnosis of neonatal infectious pneumonia（IPN）. Methods The chest X-ray（CXR） and LUS results of 80 infants with IPN clinical signs and symptoms from May 2016 to Oct. 2017 were retrospectively analyzed, and the positive diagnosis rates were also comparied.The IPN infants diagnosed by LUS were followed up to observe therapeutic effects. Results The positive diagnosis rate of LUS and CXR were respective 95%（76/80） and 81%（65/80）, in which 4 infants were CXR positive while LUS negative,15 infants were CXR negative while LUS positive. Seventy-six infants were followed up with LUS, in which40 showed a complete regression, 15 had absorptions of consolidation while with scattererd or confluent B-lines, 13 had significantly reduced consolidation, 8 had no obvious changes in size of consolidation, and 4 exhibited a ＂lung pulse＂.Conclusion LUS is of great value in diagnosis and monitor the progresses of IPN, and can be used as the preferred diagnostic method in imaging.